Workers' Compensation
Hospital Workers' Comp Claims Shouldn't Require a Specialist. But They Do.
Workers' compensation billing runs on its own forms, fee schedules, and state-by-state rules that trip up standard claims. Our specialists own the documentation and follow-up on every workers' comp claim, with automated rule checks flagging what applies.
Why Workers' Comp Claims Get Stuck
Workers' compensation claims run on a separate set of rules, and treating them like commercial claims is what gets them denied, delayed, or underpaid.
Rules That Don't Translate
First reports of injury, jurisdictional fee schedules, state forms like Pennsylvania's LIBC-9, employer verification, and carrier authorization look nothing like commercial insurance. A claim filed as if it were a standard medical claim gets denied, delayed, or underpaid.
Nobody Owns It
Workers' comp volume is lower than your commercial book, so no one on the team has time to become the specialist your revenue requires. The claims sit while staff work the higher-volume work in front of them.
Specialists, Augmented
Our specialists own the forms, documentation, and carrier follow-up on every workers' comp claim. Automated state-rule and fee-schedule checks confirm what applies, so people spend their time resolving claims, not looking up which state requires what.
Specialists Who Own Every Jurisdiction
Named specialists own your workers' comp claims end to end: the jurisdiction-specific forms, the documentation each state demands, the carrier calls, and the follow-up that gets a stalled claim moving again. Automated state-rule and fee-schedule checks run across jurisdictions to confirm which rules apply, price the claim against the right schedule, and flag the exceptions that need a person, so our specialists spend their time resolving claims instead of looking up which state requires what. You know who is working your account, and we report to you like staff, not like a vendor.
First Report to Final Payment
We manage the entire workers' comp lifecycle, from confirming compensability and coverage with the carrier, through verification, authorization, claim submission, fee review processing, and final payment. Nothing falls between the cracks because one team owns the whole process.
State-Specific Compliance
Workers' comp rules vary by state. Our specialists know the filing requirements, fee schedules, and documentation standards for every state your facility serves, from first reports of injury to jurisdiction forms like Pennsylvania's LIBC-9, completed correctly the first time.
Carrier Navigation
Workers' comp carriers operate differently than health insurers. We maintain relationships with major carriers and know their specific processes, timelines, and escalation paths. When a claim stalls, we know who to call, and when a bill-review or PPO repricing pays below the state fee schedule, we catch it and appeal it.
Denied Claim Recovery
Claims that were denied because they were filed as standard medical claims when they should have been workers' comp (and vice versa) are some of the most recoverable revenue in your AR. We identify and refile these systematically.
99%
Coding Accuracy
Across 30+ specialties, including the workers' comp coding that general billers rarely see often enough to master
84%
Collection on AR >90 Days (documented case)
One documented engagement: 375 accounts averaging 224 days old, worked with the same claim-by-claim attention a workers' comp backlog needs
25+
Years of Workers' Comp Expertise
Across hospitals, surgery centers, and multi-facility health systems
Documented results; improvements are measured against your own baseline. See how we measure
Workers' Compensation Billing FAQs
How is workers' comp billing different from standard medical billing?
It runs on a separate set of rules. Workers' comp uses different forms, state-specific fee schedules, employer and carrier verification, and authorization processes that look nothing like commercial insurance. A claim coded and submitted as if it were a commercial claim gets denied, delayed, or underpaid. Our specialists handle workers' comp claims to those rules, and automated state-rule and fee-schedule checks confirm which requirements apply before the claim goes out.
How does technology fit into your workers' comp process?
It handles the routine lookups. Automated checks run across jurisdictions to confirm which state rules apply, price the claim against the correct fee schedule, and flag exceptions worth a closer look. People own the work: named specialists complete the jurisdiction-specific forms, gather the documentation each state requires, call carriers, and run the follow-up. The technology accelerates the routine so specialists spend their time resolving claims, not looking up which state requires what.
Do you handle claims across multiple states?
Yes. Our specialists know the filing requirements, fee schedules, and documentation standards for every state your facility serves, and the automated rule checks keep those state-by-state differences straight as volume scales. That matters most for multi-facility systems where one team has to bill workers' comp correctly in several jurisdictions at once.
Can you recover workers' comp claims that were already denied?
Often, yes. Some of the most recoverable revenue in your AR is claims denied because they were filed as standard medical when they should have been workers' comp, or the reverse. We identify those systematically, correct the form and fee-schedule basis, and refile within the applicable filing and appeal windows.