Workers’ Compensation Insurance Workflow Management

On-the-job injuries and illnesses are common, with nearly 3 million reported in 2015 by U.S. employers. Of that 3 million, 2.8 million were injuries.

10.10.2017

For illnesses and injuries requiring time away from work, sprains and strains were the most common issues facing workers. Other reported injuries and ailments include fractures, bruises and cuts. Altogether, there were 1.1 million illnesses or injuries in 2015 that caused employees to miss work.

Employees use workers’ compensation claims to pay for the injuries that are treated at a variety of facilities, depending on the care needed and the insurance. Processing those claims, whether the care is short- or long-term, is often difficult because of the complexity or source of the insurance.

Working Claims

Workers’ compensation coverage varies by state with some allowing insurance to be purchased from a commercial insurance company, others permitting businesses to self-insure and still others using state-administered funds.
States and payers have strict mandates on how workers’ comp insurance can be used. Working these claims can force staff to exert significant effort to manage the revenue cycle workflow as they track data through the course of the employee’s treatment.

Attempts to manually process workers’ compensation claims are slow, time-consuming, frustrating and expensive. Variations in regulations and payers make it difficult to track the nuances of each claim. This is why it’s so important to use a streamlined electronic solution. A sophisticated software solution can help keep track of payer differences and dramatically improve the practice’s billing and payment cycles.

A single portal streamlines claims submission procedures while reducing the amount of time and manual work spent on the process. The one-stop portal reduces the amount of time and manual work spent submitting workers’ compensation claims with the ability to send batch attachments, easily converted to the correct payer format, and tools to submit clean, accurate submissions. The one-stop portal reduces the amount of time and manual work spent submitting workers’ compensation claims with tools to submit clean, accurate claims, and the ability to send batch attachments, which are easily converted to the correct payer format.

Working with a partner who has a keen understanding of the workers’ compensation process is crucial to long-term success. As workers’ compensation claims become more complex and payer requirements more sophisticated, a true grasp of the patient, provider and payer process is necessary.

Get more information now on how we can help get your workers’ compensation claims under control.
 
 

TriZetto Provider Solutions® Powered by Cognizant

We help physicians, hospitals and health systems simplify business processes and get accurate payments quickly. We will always look for new ways to help you improve revenue and increase cash flow. We will stay ahead of regulatory changes so your office will never struggle to keep up. All so you can focus on the one thing that really matters: doing what is best for your patients.

Learn More