Specialty
Workers' Compensation Billing and RCM
Work-related injury care. State fee schedules. Adjuster approvals. Timely documentation filing.
Why it’s different
Workers' Compensation operates under state-mandated fee schedules and claims adjusters rather than traditional health insurance rules.
Every claim requires accurate W/C claim numbers, employer verification, injury dates, and mandatory medical progress reports attached to every billing submission.
Common challenges
Where the money goes missing.
- Adjuster Pre-Approval
- Services performed without verified adjuster authorization resulting in denied claims.
- State Fee Schedules
- Reimbursements capped by state-specific W/C fee schedules, requiring precise fee auditing.
- Medical Report Attachment
- Claims rejected due to missing progress notes or initial doctor reports.
- Causality & Body Part Matching
- Care billed for body parts or conditions not authorized under the original injury claim.
How we help
We verify adjuster authorizations and claim numbers before treatment, attach required medical records to every submission, and audit payments directly against state fee schedules to maximize recovery.
Our team ensures full compliance with state Workers' Comp guidelines and manages direct follow-up with insurance adjusters.
Key codes
- State W/C Fee Schedule
- Doctor Initial / Progress Report
- CPT 99202–99215
- W/C Claim ID
Indicative, not exhaustive. Code sets and payer policies change.
Get a Workers' Comp Billing Audit
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