Workers' compensation claims
Work injury care is billed to the employer's workers' compensation carrier or program, using its claim number and fee schedule. Each state runs its own system, so a clinic near a state line may follow two sets of rules.
Work injuries need a different payer path
An occupational medicine clinic bills workers' compensation carriers, employers, and health plans, sometimes for the same patient. Sending a work injury to the wrong payer delays payment and can mean refunds later. Bring your service mix and Taiga will tell you straight whether it fits.
Book a demoThree payers, three sets of rules
Occupational medicine billing starts with routing each visit to the right party.
Injured federal employees
Federal workers are covered under the Federal Employees' Compensation Act. Providers must enroll with the Department of Labor's OWCP program to be paid, and bills go through its portal, EDI, or paper process.
Medicare as secondary
Medicare does not pay for services that workers' compensation has paid or can reasonably be expected to pay. For older workers on Medicare, the injury claim goes to the comp payer first.
Drawing the line on employer services
Some occupational health work is a claim and some is an invoice. Sort them before handing anything off.
The clinic keeps
Injury reports, work status notes, and employer contracts for services like pre-employment physicals and drug screens. Physicians approve every code Taiga drafts for insurance claims.
Taiga takes on
Coding drafts, claim submission, scrubbing against payer rules, and follow-up on denials and appeals for the claims in scope, plus patient statements where a balance remains.
Needs a decision
Whether workers' compensation bills, which often need claim numbers and attachments, are in scope, and who invoices employers directly for contracted exams and testing.
Questions for an occupational medicine call
Bring de-identified examples of an injury claim, an employer-paid service, and a regular health plan claim.
Which states and programs do you bill?
List each state workers' compensation system and any federal OWCP cases.
How much is employer-paid?
Separate contracted employer services from insured care, and describe how you invoice employers today.
Where do comp claims stall?
Note whether delays come from missing claim numbers, attachments, carrier disputes, or authorizations.
For clinics that mix injury care and everyday care
Most useful for an independent occupational medicine or urgent care clinic whose insured claims and comp follow-up have outgrown the front desk.
Workers' comp support is a fit question
Occupational medicine is not among Taiga's named specialties, and workers' compensation billing is confirmed program by program. Direct employer invoicing may stay with your team.
Questions about occupational medicine billing
Can we bill Medicare for a work injury?
Not as the primary payer. Medicare does not pay for services that workers' compensation has paid or can reasonably be expected to pay, and generally pays only after workers' compensation remedies are exhausted.
Do we need to enroll to treat injured federal employees?
Yes. Providers must enroll with the Department of Labor's OWCP program to be paid for treating an injured or ill federal worker. Enrollment is free.
Are pre-employment physicals billed to insurance?
Usually they are paid by the employer under a contract rather than billed to a health plan. Confirm each employer arrangement before treating it as a claim.
Can Taiga run alongside our current billing during the switch?
Yes. Taiga can run in parallel at first or take over open A/R, and onboarding takes about two weeks to the first claim.
Bring your payer map
Sort your visits by comp, employer, and health plan. Taiga will tell you straight whether it fits and which parts it can take on.
System guides show possible billing handoffs, not proven specialty compatibility.