Workers’ Compensation Insurance Workflow Management

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.

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.

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.
Blog Comments

Dr. Jeffery Todd Reed
The constant expenditure of spinal surgeries and PT continue to increase. To save millions, I would suggest care such as a qualified Chiropractic specialist initially concerning spinal issues. They can make the appropriate referral. Example: each patient using PT can cost 125-400/daily x 3 days a week. @250.00 its at 750.00 a week 8 weeks or 6000.00. After practicing for 19 years its laughable that $30.00 is paid for an ice pack on some scales. The absurd thing is applied by a PTA $30, by a Chiropractor $0. So a company is paying a 2 year educated individual 30, and an 8 year educated person $0. The bottom line is that fraud is causing everyone to hemorrhage money. Combine that with providers that are suppose to be portals of care over prescribing procedures and meds at times.
2/2/2018 10:43:16 AM

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