Training Resources
Training Resources
All of the following are needed to perform a complete case review of unapproved claims:
New Patient Information (Intake) FormCA1 or CA2Doctor’s Initial NarrativeDOL Denial Letter(s)Any written patient statements
In the course of working on denied and unaccepted OWCP cases, the case manager will need all of the above documentation in order to completely evaluate each case.
The case manager will request this information on individual patients or on blocks of patients.
The patients’ information requested will be uploaded to the EMR by a designated person in each office.
Once all needed information is received by the case manager, the information will be reviewed and recommendations will be made to medical providers about how to improve documentation in order to help get claims approved. (Note: At no time, will any non-medical personnel make any recommendations with regard to medical decision making.)