The Bureau of Workers' Compensation is the payer for a work injury. There is no private workers' compensation carrier. The Ohio Department of Medicaid runs the program. Managed-care members are billed to their plan. Fee-for-service Medicaid is a separate submission. Next Generation MyCare is the managed-care program for members who have both Medicare and Medicaid. It is not the same plan as a Medicaid-only member.
The Bureau of Workers' Compensation is the payer for a work injury. There is no private workers' compensation carrier.
The Ohio Department of Medicaid runs the program. Managed-care members are billed to their plan. Fee-for-service Medicaid is a separate submission. Next Generation MyCare is the managed-care program for members who have both Medicare and Medicaid. It is not the same plan as a Medicaid-only member.
Ohio is a monopolistic fund state. A work injury is billed to the Ohio Bureau of Workers' Compensation. Sending that bill to a commercial health plan, or to a private workers' compensation carrier from another state, is the wrong payer.
Medicare Part A and Part B for an Ohio practice go to CGS Administrators, Jurisdiction 15, with Kentucky. Michigan and Indiana use WPS Jurisdiction 8. Pennsylvania and West Virginia do not use CGS.
Ohio is one of four states where workers' compensation is a state fund. That single fact changes the payer on every work injury. Medicaid plan billing and CGS Medicare billing stay on their own files. Kentucky shares the Medicare contractor and does not share the Bureau of Workers' Compensation.
The Ohio Bureau of Workers' Compensation. Ohio does not use private workers' compensation carriers.
CGS Administrators, Jurisdiction 15, the same contractor as Kentucky.
The fee is a percentage of net collections. The written rate follows volume, specialty, and how much of the cycle you hand over. There is no setup fee, and the agreement is month to month. The state is not a surcharge. How pricing is set.
