e-billing Rules to become effective July 1, 2018
The Tennessee Bureau of Workers’ Compensation’s Rules regarding Electronic Medical Billing for Workers Compensation Claims have been filed with the Secretary of State and will become effective July 1, 2018.
These rules provide a legal framework for electronic billing, processing, and payment of medical services and products provided to an injured employee and data reporting required by Tennessee Code Annotated § 50-6-202 and can be found on the Tennessee Secretary of State's Official Compilation of Rules and Regulations.
In preparation of the full implementation of the rules, payers should be able to exchange data electronically by January 1, 2018 and healthcare providers or their agents should be able to exchange this data by June 1, 2018. However, in response to public comment regarding questions about these dates, the mandatory implementation date for all parties was changed as is reflected in the final section of the rules, which reads as follows:
0800-02-26-.10 Effective Date
(1) These Rules are required for all medical services and products provided on or after July 1, 2018. For medical services and products provided prior to July 1, 2018, medical billing and processing shall be in accordance with the rules in effect at the time the health care was provided unless both payer and provider elect to comply with these Rules.