Define and explain temporary disability claims. What is the role of the state in such claims? The medical biller? The claims examiner?
What will be an ideal response?
Answer:
Temporary disability claims are when the patient is not able to perform her job requirements until she recovers from the injury involved. When a physician sees a patient in this situation, a First Report is submitted and ongoing reports are issued every two to three weeks until the patient is discharged to return to work.
Each state has a waiting period before temporary disability becomes effective, usually three to seven days. During temporary disability, the employee is paid a portion of her salary as a tax-free benefit. Temporary disability ends when the patient is able to return to work, even with limitations or to a different department, or when the patient's condition ceases to improve and the patient is left with a permanent disability. Most healthcare plans do not have a disability benefit or death benefits. Therefore, the medical biller should check the health insurance before submitting such a claim. The health claims examiner should not receive a disability claim unless otherwise provided in the insurance plan. If one is received, it should be denied as not a covered benefit.
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