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Provider Resources

Medical Providers

Securely upload medical files for expedited invoice processing, submit a bill reconsideration, request bill status updates, and find other helpful information below.

Billing

All invoices must be submitted to Prescient National; please do not send invoices to the employer or injured worker.

Medical Bill & Medical Records Upload

For expedited invoice processing, set up a direct eBilling account with WorkCompEDI. Click here for instructions on how to set up an account.

Alternatively, providers can securely upload and submit medical bills using the File Upload option below. All charges must be submitted on CMS 1500 (HCFA), UB04 Form, or accordingly on each state’s industrial commission approved claim form.

Medical bills must be submitted with medical records.

Medical Bill Reconsideration​

Bill Reconsiderations must include a completed Appeal Form, medical bill, original EOB, and notes associated with the visit.

Click here for the Appeal Form.

Status of Bill

We make every effort to pay or deny bills within 30 days. If, after 30 days, you have not received payment or denial, please complete the form below. A representative will be in contact within 1-3 business days.

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*Do not include $ or commas in the Billed Amount field.

    Name*
    Claim # or Injury Date
    Employer
    Billed Amount*
    Medical Provider Name*
    Date of Service*
    Contact Name
    Phone *
    Email*
    Fax
    Bill Submission Date*

    W-9 Form

    Medical providers must complete a W‐9 form and submit to Prescient National to receive payment for Workers’ Compensation claimant invoices. Click here to complete the W‐9 form.

    Signed and completed forms can be uploaded using the link below, faxed to 704-927-2867 or emailed to providerw9@prescientnational.com

    Pre-Authorization Reviews

    Please be aware that Prescient National may conduct Pre-Authorization reviews in North Carolina, Georgia, and Illinois.

    North Carolina Providers, please click here for our North Carolina UR Plan.

    Provider Forms

    Click on the links below to access medical provider forms:

    Essential Workers’ Compensation Programs

    The following key programs are essential to Prescient National’s Workers’ Compensation claims. Our goal is to aid the injured employee to reach maximum medical improvement as quickly as possible.

    Post-Accident Drug Screen

    Prescient National requires a 10-panel drug screen to test for the use of THC, cocaine, opiates, amphetamines, phencyclidine (PCP), benzodiazepines, methadone, oxycodones, barbiturates, and buprenorphine.

    Prescription Medications

    Prescient National utilizes Optum as our Pharmacy Benefit Manager. Coverage includes prescription medications necessary and appropriate for treatment of accepted conditions resulting from workplace injuries.

     

    Please note: Physician dispensed medications are not authorized/honored by Prescient National.

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