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Understanding the workers’ compensation recovery process
Although workers’ compensation only makes up approximately 5% of a provider’s payer mix,
these cases are considered an outsized source of frustration for medical providers, frequently resulting in underpayments, delays and lost revenue. Why? It’s complicated, but it usually can be attributed to one of three things:
Business office education
Staff often isn’t well-versed in the right general processes and procedures for workers’ compensation cases.
Regulatory updates
State and federal regulations are continuously in flux
Payer policy changes
Insurance companies often alter their rules with little notice or fanfare.With access to the right intelligence, however, the vast majority of workers’ compensation claims don’t need to be written off. As experts, Comp Recovery ensures providers get the workers’ compensation reimbursement they deserve and the real profit to which they are entitled. Using our no-risk, no-cost analysis, we evaluate your closed billings to learn what was overlooked. Here’s our four-step approach:
Initial analysis
We download a sample of workers’ compensation data to estimate the potential scope of the underpayments.
Documentation review
Typically, we then select 10-15 cases at random and review the payer contracts.
Recovery
If there’s a discrepancy between the contract and the payment, we contact the payer and begin the initial compensation recovery process.
Engagement
Based on the initial findings, the provider decides whether to formalize our engagement; if so, the provider’s entire dataset is analyzed for underpayments and the recovery process is expanded.Our track record
Interested in learning more? Let’s talk. Working with Comp Recovery means no more legal fees. Leveraging our well-established relationships with re pricers and insurance companies, we help you recover more money by diagnosing the specific issues at your facility and posing solutions. We start by assessing whether past claims have been paid properly, and the ultimate course of treatment depends entirely on the severity and appropriateness of underpaid workers’ compensation claims and your desire to make improvements. Our proprietary processes and technologies allow for maximal flexibility, making certain that important community interests and relationships are respected.