Workers’ compensation in medical billing is a service which refers to the insurance compensation paid by the carriers to workers for their medical treatment of illness or injuries that happened due to employment or when on the job. It is mainly dependent on the current worker’s compensation policy of the state. Employers in most cases buy commercial workers’ compensation policies from the insurance provider directly.
In a statistic, it is revealed that workers’ compensation claims comprise of about 2-3% of all medical spending.
Workers ‘compensation claims create unique and different challenges to their claim follow up agents and billers. It can be improved significantly by ensuring that the appropriate processes set up the payers are followed.
With legalities involved, this process has a lot of challenges, limitations and several conditions and requirements to be approved, billed and processed. Also, to add on, the guidelines differ from one state to another making the process more complex. Workers’ compensation and billing seem like a stressful process involving all the legal nitty gritty. From the terminologies, forms, applications and procedures the entire process is very specific and unique.
BIS offers the ultimate solution for your workers compensation billing. Outsource your medical billing and collections systems to us to ensure that the entire process is hassle free.
Out tedious and methodical processes will help increasing your revenue and also in reducing the turnaround time of payments.
Our dedicated team of workers compensation billing and collections experts along with the legal team have rich experience in handling various cases with regards to workers’ compensation. They are also up to date on the various changes that happen frequently in this. This helps a lot in ensuring that the process is not outdated. With being on top of the current scenario, payments are collected faster without any challenges and lags. This speed up the entire collection process and turnaround time.
We majorly focus on the accuracy of the medical coding which minimizes the rejections to a large extent.
Our internal quality teams help us to stay improvised in our processes. There is consistent review mechanism for the entire process and SOPs are regularly improved and updated. We ensure that our services in this space are on top in comparison to our competitors.
We are one of the leading workers’ compensation billing and collections company. We not only provide workers’ compensation billing and also couple it with workers’ billing collections so that the entire revenue cycle management is taken care. This complete solution makes stand tall among our competitors.
Our members of the billing and collections team stay on top of any new legislations, bills, regulations etc. passed in reference to the workers’ compensation billing and collections. Constant training is provided to our staffs to ensure the right processes are followed.
The operational strategies and workflow are managed meticulously by our team. All necessary regulations are strictly followed upon which increases the percentage of approvals steeply.
Our process starts from taking up the case, reviewing the same, collect all required data relevant to the case, raise pre-authorization to ensure approvals of claims faster, create medical coding accurately, and submit the billing forms to WCB, review and follow up on payments, denial management, second bill review and collection of payments.
Taking up the case- Intake of the case is very critical and crucial in the entire process. The insurance carrier must verify the entire employment and injury details of the worker and ensure that it is a valid case in Workers' Compensation Appeals Board (WCAB).
Collection of data and Review and Verification of the case – When the case has been approved and treatment is undertaken, other data pertaining to the case and processing of payment are collected and they should be thoroughly verified. The insurance details must also be verified to understand any adjusters etc.
Raise pre-authorization request – Raise pre-authorization request for approved case. This is a mandate process. This is to substantiate required treatment for the patient. Also, it will help in faster clearance of bills and collections.
Accurate medical coding – Once the authorization is received and medical treatment is complete, the necessary medical reports are obtained. Basis the reports, coding is done for medical billing. The created codes are checked thoroughly to ensure that medical coding is as per the current and revised standards.
Creation and submission of forms – Basis the medical reports and coding, the bills are created and submitted to the carrier for payments. Timely submission of bills is very important for the timely clearance and collection of the payments.
Denial management and review – There may be times, when the bills are rejected due to various reasons. Also, at times, the payer does not pay the entire amount eligible. These bills are scrutinized for reviewed further. Second bill is submitted with the required explanation within the stipulated period of time.
Collection of Payments – Once the bill is through without any errors, timely and constant follow up is done with the insurance payers to collect the payments in least time possible.
We at BIS will help you make more money in workers compensation billing. Outsource workers’ compensation billing and collections to us and stay at ease! We manage the end-end workers’ compensation billing and collections process and help enhance your revenue.