Workers' compensation in medical billing are provided by carriers to employers to cover treatment for illness or injuries that happen to their worker as a result of employment. As a service, workers' compensation billing entails a lot of guidelines marked by several requirements and limitations. These guidelines differ from state to state, making the processing of these services very complex. Additionally, workers compensation billing needs to be processed manually as they require greater oversight.
Outsource2india has over 2 decades of experience in handling workers compensation billing services for its US-based healthcare providers. Over the years we have assisted our clients submit bills by following basic workers billing compensations steps such as getting proper authorization, ensuring compliant billing, maintaining the tariffs as determined by the regulatory body, documenting bills properly and submitting them electronically. As a leading workers compensation billing service providing company, we reduce the time and effort needed to obtain proper reimbursement.
As a reputed workers compensation billing service providing company we provide comprehensive workers compensation billing services. Our services include -
This is a very critical part of workers billing and entails proper and correct input of information. Unless done correctly it may lead to denials. We ensure that important information such as injured worker's name, mailing address and date of birth, current claim number, date of injury, area of injury and diagnosis, date of initial and subsequent visits, tariff codes and fees, WCB account number, including address, fax and phone and fax number are properly included. After the information is included, we cross check it for accuracy.
Once the processing of remittance is done a statement is issued by the carrier. We review the statement to ensure the details of what was paid to an injured worker is correct with what was submitted. This review of statements helps our clients reconcile their records.
If claims are denied, we assist you with handling denials. We first try to establish the reason for denial and if it happens to be a case of mistaken paperwork we contact the claims adjuster to clarify the problem and resubmit claims. If the insurance company refuses to accept the mistake, we assist our clients get in touch with an attorney to appeal the denial of the claim. In case it doesn't work out we assist our clients with additional levels of appeal depending upon the state rules.
The fees for medical aid is determined by the WCB's legislative authority and is different for different practices. Each service provided to an injured worker has a different tariff. Most of these tariffs are specific to the WCB. We help you understand these specific tariffs which includes physician tariffs, chiropractor tariffs, physiotherapist tariffs, pharmacies, nurse practitioner tariffs, vendors and hearing aid clinics tariffs etc.
We also assist our clients in managing their entire account receivables process in order to guarantee the best outcomes for their business. Our services for end-to-end revenue management includes coding and billing, collections of outstanding, payer and patient relations, fee analysis, client reporting, review different payers for workers compensation benefits etc.
We follow a definite billing process to ensure our clients get full reimbursements. Our workers compensation medical billing process entails the following steps -
Once an employee visits a medical provider to receive benefits a written notice of the injury is obtained as soon as possible from the employee or employer. At this stage we verify the injured worker's employment and injury history, on behalf of the provider.
After verifying employee credentials, we meticulously verify the full details of the insurance company with details on adjusters, case status, body parts, etc.
In this stage, we request for authorization to kick-start the utilization review process as required by Labor Code section 4610. The request is supported with doctor's first report of occupational illness or injury, Form DLSR 5021, DWC Form PR-2, a treating physician's progress report etc. to substantiate the required treatment.
After obtaining the authorization and the treatment is carried out, we procure the medical reports to ascertain the afflicted body parts and treatment carried out. Based on the reports and procedures we carry out coding. The coding is checked for accuracy multiple times because codes for workers compensation are updated frequently.
After the quality check, the bills are ready for submission on the carriers portal. Though regulations stipulate bill for payment within 12 months of providing a service, we ensure submission is completed soon enough for early reimbursements.
We do regular follow ups to ensure reimbursements are on time. As insurance companies need to pay providers within working 15 days of receiving a bill, we pursue a bill payment much before the deadline.
In case the payer does not actually pay the full amount, we scrutinize the payment and explanation of benefits, and file the second bill review within 90 days of submission. If the bill is still not properly paid, we take all the necessary steps to initiate an independent bill review.
Outsourcing Workers Compensation Billing Services helps healthcare providers with a host of benefits. Some of the salient benefits include -
We manage your entire account receivables process to ensure you can focus on your core tasks. We take care of important revenue cycle aspects such as billing and coding, collections, payer and provider relations, fee analysis, client reporting, review of workers compensation payers etc.
Our services are cost-effective and help you improve collections in a number of ways. Our well-defined bill submission process followed by constant follow-up and tracking helps you have complete control over your revenues. You get all money owed to you on time and ensure there are zero denials.
We follow all the important HHS compliance laws. We have tools and practices in place to protect Health Information in electronic and physical form. We have developed highly secure procedures for employees to handle information, and how to tackle security breaches. Finally, We keep ourselves updated with latest rules and ensure there are no violations whatsoever.
We assist our clients reduce their expenses and expedite their processes by using our the most advanced software in the market. Our billing specialists are familiar with all major billing systems and can even work with your existing management software.
As a trusted workers compensation billing service provider, we assist our clients to provide complete transparency about pricing to their clients. We also ensure that there is no confusion whatsoever in making clients understanding billing statements. Our commitment to exceptional WCB billing services assists in enhancing patient experience. This in turn guarantees prompt payments.
We have our presence in 8 global delivery centers. As a result, we are well equipped than our competitors in providing round the clock services to our clients. We rely heavily on our cloud technology and architecture to send patient and financial information to our clients.
We deliver the right kind of customer support to your clients. We are courteous and respectful with all your clients. We train our executives to use plain terms and simple explanations to help them understand issues. In the process, we ensure your brand image is maintained.
Read this case study to know how O2I's management training support helped a billing company headquartered in Florida migrate from the ICD-9 to the ICD-10 system.Read more
From this case study, you'll learn how O2I's service enabled a healthcare company's accounts receivable and cash flow to recover after a series of denials.Read more
Hello, I wanted to reach out to you directly and express my gratitude for the hard work that the Data team, as well as the AR team, has done with EJ practice. I have pushed both teams extremely hard over the past month and their efforts, as well as ours, have paid off.RCM Account Manager,
Outsource2india has over 2 decades of experience in providing services for workers compensation billing to healthcare providers in the US. Our wide experience in handling the various complexities of workers' compensation billing will help you eliminate the difficulties faced while billing in-house and boost the profitability of your practice. Additionally, our strict compliance to HIPAA standards and guidelines will guarantee there are no security breaches or costly errors. At the same time, our commitment to transparency will help you get complete reporting on your financial data on time.
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