Workers compensation runs on a state fee schedule, state forms, and state timelines. A process that works in one state is frequently invalid one state line away, which is why it is so often the worst-performing segment of a practice’s A/R.
Comp claims are billed to the schedule that governs them and followed up on the timeline they actually run on.
At a glance
Step 1
Bill against the applicable state fee schedule rather than your commercial rates
Step 2
Track authorization and reporting requirements specific to the jurisdiction
Step 3
Manage the documentation these carriers require and commercial payers do not
Step 4
Follow up on the longer payment cycles these claims run on
What we actually do
- Bill against the applicable state fee schedule rather than your commercial rates
- Track authorization and reporting requirements specific to the jurisdiction
- Manage the documentation these carriers require and commercial payers do not
- Follow up on the longer payment cycles these claims run on
What this fixes
- Comp claims billed at commercial rates and paid at schedule
- Missing state-required forms that stall a claim indefinitely
- Comp A/R aging quietly behind the rest of the book
We work the claims. You practice medicine.
Coding, claim submission, denial management, and A/R follow-up — with nothing left for your front desk to chase.
View pricingHow It Works
Review
We look at how this runs today and where it leaks.
Scope
A written scope and price before any work starts.
Transition
We take it over without a gap in submission.
Report
The same six numbers every month, so you can see it working.
Workers Compensation Billing — Frequently Asked Questions
Do the rules really differ that much by state?
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Yes. Fee basis, forms, authorization, and dispute processes are all set at state level, which is why we price and staff this work per state.
How is workers compensation billing priced?
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It is included in ongoing revenue cycle management, which is priced as a percentage of collections banded by practice size — or as a flat monthly fee in states that do not permit percentage compensation of a billing company. Front-end services are also available on their own, per occurrence, without a billing contract.
Do you guarantee a result from workers compensation billing?
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No, and nobody honestly can. Coverage, adjudication, payment amounts and appeal outcomes are decided by the payer. What we commit to is the process and the six numbers reported every month, all of which you can reproduce from your own practice management system rather than take on trust.
Can we buy workers compensation billing without moving all of our billing?
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Front-end services are sold per occurrence and stand alone. The back-end work is harder to separate — denial management without control of coding and submission means inheriting problems created upstream — but we will say plainly which parts make sense on their own rather than sell a partial engagement that cannot succeed.
Ready for books you can actually trust?
Book a free consultation and we will tell you what your revenue cycle needs and what it costs.
- Done-for-you
- Solo or group
- Nationwide
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