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workers comp and auto-related claims

Kim Ross 3 months ago in Billing/Electronic Modules updated by Mark Cornell 2 weeks ago 7

Good morning!

We have an ongoing battle trying to get reimbursements from workers comp or auto-related claims. It's a relatively small amount of reimbursement -- usually -- but, it takes an inordinate amount of time for our staff.

Curious how the rest of the Procentive Community deals with these types of claims. Do you accept workers comp and/or auto?

Thanks for your feedback!

Best,

Kim

We have accepted both workers comp and auto-related claims.  They do require more work, but we eventually get paid on them.  With both of them, we have had to submit the session notes along with the billings in order to get paid though.  Also on auto-related ones, we have had to have our HCFA form state that the session was related to an auto accident of which is not automatically done right now in Procentive.  I was informed by Procentive that I would have to manually edit the paper version of the claim and send it via paper.  When I asked Procentive about it being done automatically, I was informed that, that wasn't an option at this time, but I have been pushing for it, because with the amount of clients/payers, it is sometimes hard to remember who is who and the need to go in and do this manual edit would be something hard to remember.  I have asked for it to be an option within the client's main screen, because another client could have that same insurance but it is not related to an auto-accident...they said it would be a future feature enhancement at this time.  =(

Interested in hearing who has had success with this. It seems to be hit-or-miss with us.

I have had good luck with these types of claims. But, I have not had to bill alot of these types of claims. I always do my prep work first.  I always get a direct contact name, phone number of a Rep, and a case number if one has been assigned. I do call them prior to any client appointments.  I ask if they will pay for mental health visits, how many, how they want to receive the billing and what to include with the billing and they have always followed through with payment.

I had gotten a direct contact and auth for LM and now they are requiring we supply information that we do not have for Mental Health claims.  Frustrating...

Does anyone require clients to prepay until the workers comp claim is settled? 

We've waiting months and months for reimbursements on these, not to mention the staff time that goes into getting them paid.

What is the client responsibility for payment? 

Any insight is appreciated.

Thanks,
KIm

Same...LM we had Procentive create a new payer for LM claims for work comp and they still are denying them.

We have provided all asked info and sent a bill. I have an email from the worker approving the sessions so I am just going to send it to collections