Alabama Workers Compensation Law

Some more definitions from the Act itself

Section 25-5-1

Definitions.

(20) BILL SCREENING. The evaluation and adjudication of provider bills for appropriateness of reimbursement relative to medical necessity and prevailing rates of reimbursement, duplicate charges, unbundling of charges, relativeness of services to injury or illness, necessity of assistant surgeons, adjudication of multiple procedures, number of modalities, global procedures, and any other prevailing adjudication issues that may apply.

(21) ADJUDICATION. The review of claims to apply prevailing rules that adjust reimbursements for the amount of work required when multiple procedures are performed at the same time, when assisting surgeons are present, to eliminate duplicate billing from the unbundling of global fees, and to adjust for the most commonly occurring method adopted for total reimbursement.

(22) OMBUDSMAN. An individual who assists injured or disabled employees, persons claiming death benefits, employers, and other persons in protecting their rights and obtaining information available under the workers' compensation law.

 

If you read back over the last few days of posts you will see the defintions as they appear in the compensation act of Alabama. The definitions are a key element of applying the law in the state.  It is important to remember that it is up to the court system how to interpret these various definitions and they may be given different interpretations by different lawyers, courts and judges. In the near future we will be posting other key parts of the Act.

Alabama Workers Compensation Law

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