The feature to support USDOL claims processing in Therabill is currently in Limited Release to a select group of members and will be gradually rolled out in the future. This article reflects the new updates to come.

To meet the U.S. Department of Labor (USDOL) Office of Workers’ Compensation Programs (OWCP) billing requirements, a new USDOL Number field has been added to three locations in Therabill. Members must add their USDOL Number in at least one of these locations for claims to be generated successfully.

Where to Add a USDOL Number

To submit USDOL claims electronically, add your USDOL number in one or more of the following locations:

• Member (Billing Provider) Info
• Service Facilities
• Provider Groups

Once added, USDOL claims can be submitted electronically through Therabill as expected. 

Member (Billing Provider) Information

To add a USDOL # to the Member (Billing Provider) Info section: 

1. Navigate to Admin > Member Info.
2. Select Edit.
3. Add the USDOL # and click Save changes.

Service Facilities

To add a USDOL # to a Service Facility: 

1. Navigate to Admin > Member Info.
2. Select the blue pencil icon for each Service Facility.

3. Add the USDOL # and click Save changes.

Provider Groups

To add a USDOL # to a Provider Group:

1. Navigate to Providers > Groups.
2. Click the blue pencil icon for each Provider Group.

3. Add the USDOL # and click Save changes.

How Therabill Selects the USDOL Number for Claim Submission

When generating claims for Department of Labor (DOL) payers (Payer ID 77044), Therabill will determine which USDOL Number to include on the claim in the following order: 

1. Provider Group USDOL Number (if the provider belongs to a Provider Group)
2. Service Facility USDOL Number (if a session has an assigned facility that is not the default Billing Address)
3. Member Info USDOL Number (the practice-level default)

The selected USDOL Number will appear next to the billing provider name/address in Box 33 of the CMS-1500 Form.

Error Handling

If no USDOL Number exists in any location and a claim is submitted to the USDOL, the system will generate an error message and the claim will not be submitted.

The member must enter their USDOL Number in 1 of the above 3 areas before attempting to submit the claim.

How to Find a USDOL Number in an EDI 837 File

The USDOL Number will appear in Loop 2010B - Payer Name of an EDI 837 File.
 

Format: REF*G2*[9-DIGIT USDOL #]~
Location: This will appear immediately after the NM1*PR (Payer Name) segment

Example: 

NM1*PR*2*US DEPARTMENT OF LABOR*****77044~

REF*G2*747553800~

N3*200 CONSTITUTION AVE NW~

N4*WASHINGTON*DC*20210~