When it comes to workers’ compensation billing, there are so many rules and processes to be followed that by the time everything is done, providers end up losing money on the claims. There are several reasons why many providers choose to outsource workers’ comp billing to a third party. For instance, there is no single set of rules for such claims. Every state has its own complex status and fee schedules for workers’ compensation. If not adhered to, claims are likely to get rejected.
Workers’ compensation is very specialised. If the provider fails to capture the accurate insurance information, the claims will get submitted to the wrong payer or to a third party administrator. This will delay reimbursement and also pose risks for violation of state filing requirements. There is also a strong need to verify the initial authorisation before a provider files a claim under workers’ comp. If there is no pre-authorisation that confirms that the employer believes the injury to the employee occurred on the job, then it will impact the chances of all claims and reimbursement procedure.
Another reason that makes workers’ comp claims complex is the need to file out the claims on paper along with the right attachments before mailing them to the insurance carrier. This time-consuming, labor-intensive procedure takes the focus of the staff away from quality care. This makes such claims costlier than electronic filing.
These are some of the reasons why many providers are choosing to outsource. By choosing a reputed billing partner, they are boosting the profitability of their practice or hospital and eliminating the stress of in-house billing.
What to expect from a billing company?
The billing company will not only deal directly with the personal injury insurance carriers on your behalf but also handle the following services:
- Verify benefits
- Obtain an authorization,
- Prepare and submit claims,
- Process fees reviews as per the workers’ compensation act,
- Handle denied claims,
- Audit and resubmit outstanding claims,
- Improve collections,
- Offer financial and management reporting,
- Ensure transparency through the revenue cycle, offer round-the-clock remote access to patient and financial data,
- Ensure compliance with HIPAA and offer superior customer service,
Since your workers’ compensation billing will be in professional hands, you can enjoy peace of mind and focus on the vital task of delivering quality care to the patients while watching your cash flow increase.