Services
Workers Compensation
The attorneys at Medical Accounts Systems have the capability and experience to interpret the mandates of each state’s workers compensation statute and ensure that the provider secures the maximum allowable recovery.
MAS provides a unique approach to worker’s compensation claims by ensuring that the claim is reviewed by an experienced healthcare attorney immediately upon receipt of the claim. This attorney works closely with representatives of worker’s compensation carriers, counsel for the patient, and human resources departments for the employers to obtain all necessary information for proper and prompt filing of the claim. Further, this attorney is responsible for providing all applicable supporting documentation to guarantee timely consideration and payment of the claim.
Case Study
Issue:
Worker’s Comp (“WC”) was billed on December 18, 2018, and on January 9, 2019, Facility received correspondence requesting the submission of patient medical records as well as the actual claim. WC stated that requested documents were not submitted until mid-April 2019, and denied for timely filing.
Analysis:
MAS contacted WC and presented the argument that in the state where the services were rendered, there is no timely filing requirements for an original bill. It was discovered that the submission of the requested documentation was processed as a Reconsideration Request, and not an original bill. MAS worked with the WC adjuster to appeal for an override of the denial on the basis that the facility was submitting requested documentation and that a timely filing denial was not applicable. Following several discussions between MAS and the WC adjuster, the WC system was updated to reflect the submission of medical records and the original bill.
Solution:
WC remitted $9,457.94 payment in compliance with the State fee schedule for WC on May 8, 2020.