This guide provides step-by-step instructions to create a Workman's Compensation (Workman's Comp) case and configure the associated policy in ChiroHD.
Step 1: Create the Workman's Comp Case
Access the Patient Profile:
Search for the patient using the search bar or click the patient’s name directly from the calendar.
Create a New Case:
Click Cases > Create New Case.
Set the Type as Workman's Comp.
Billing Status:
It is common practice to select Billing Suspended for Workman's Comp cases.
Reason: Many insurance companies or attorneys prefer to receive billing documents (such as statements and SOAP notes) only after the case is fully resolved, rather than receiving bills weekly.
Save the Case:
Click Save Changes.
(Optional) Set the case as the Default Case if it is the active treatment case for the patient.
Step 2: Add Diagnosis Codes (DX Codes)
Open the Workman's Comp Case.
Navigate to the Treatment DX Section.
Add Diagnosis Codes:
Click into the search box and either type the diagnosis name or ICD-10 code.
The system defaults to today's date. Adjust the Start Date if needed by using the date picker.
Tip:
If you set the start date on the first diagnosis code, all subsequent codes will automatically use the same date.
Save Changes.
Step 3: Set Up the Policy Information
Go to Insurance SL Coverage.
Click Add New Insurance SL Coverage.
Complete Policy Information:
Insurance Company/Attorney: Select the appropriate third-party payer (must be pre-created).
Priority: Set as Primary.
Coverage Dates: Input the start date from the Workman's Comp case documents. The end date can be left blank if unknown.
Claim Number: Enter the claim number provided by the insurance or employer.
Additional Required Information:
Claims Related To: Set to Work (for a work-related injury).
State of Incident: Select the state where the injury occurred.
Maximum Coverage: If available, enter the maximum covered amount for medical claims.
Date of Injury: Input the date the work-related injury occurred.
Onset Qualifier: Select Accident.
Optional Fields:
Complete Box 19 if necessary for additional notes.
Accept Assignment defaults to Yes and can be modified if required.
Referring Provider is typically not required for Workman's Comp cases.
Save the Policy Information.
Step 4: Configure Default Services (Optional)
Navigate to Default Services.
Add services that should auto-apply whenever a SOAP note is created under this case.
Click Save Changes.
Step 5: Manage Billing and Settings
Suspended Billing:
If billing is suspended, services will not appear on the Create Bill screen.
When ready to start processing claims, update the billing status to Bill Normally.
Monitor Suspended Billing:
To easily identify cases still set to Billing Suspended, use:
Reporting > Simple Reporting > Health Check > Billable Items on Suspended Cases.
This report helps ensure no services are forgotten when ready to bill.
Edit Case Settings:
You can update the case Name if needed, but do not change the Case Type unless necessary.
Important Notes
Confirm with the patient's employer, insurance company, or attorney whether billing should be suspended or sent regularly.
Ensure third-party payer setup is completed before creating the policy.
Regularly monitor suspended cases to prevent delays once settlements are reached.
By following these steps, you can correctly set up a Workman's Compensation case and ensure proper tracking, billing, and reporting for your patients.