Workmans Compensation

WCA Claims

 

For many health care practices billing of injury on duty cases (WCA Claims) is not only time consuming and frustrating but often there is uncertainty as to how the billing should be done in order to ensure that the practice is able to receive prompt payment from the Workman’s Compensation Commissioner.

Better Practice Management is able to provide the following services, which will ensure that your practice is able to receive prompt payment from the Workman’s Compensation Commissioner for Injury on Duty WCA claims. The turnaround period between date of submission of the claim until receipt of payment is approximately 8 weeks, however claims that are older than 1 year will take longer to be complete as the documentation has to be drawn out of achieves at the Workman’s Compensation Commissioner and the case needs to be reopened.
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Better Practice Management offers full WCA Claims management, which includes:

  • Complete account management of Workman’s compensation claims which include
  • Opening of accounts
  • Submitting of accounts to the various Workman’s Compensation Commissioners
  • Collection of reports from all doctors who treated the patient

Credit Control of  WCA Claims which have been repudiated which may include:

  • Sending account to the Employer/ patient for payment
  • Sending a reminder letter
  • Final Demand letter to Employer’s/patient who did not respond to the reminder Letters
  • ITC® (Information Trust Corporation) listing as Bad Payer of Employer’s or patients under Better Practice Management’s name who did not respond to the Final Demand letters
  • Constant follow up on the progression of the WCA claims
  • Personal Liaising with the Commissioners

Strategic planning which includes:

  • Setting up of systems for WCA Claims

Practice figures which will include:

  • Age analysis of Injury on duty claims which have been submitted
  • Payment analysis

What does the Practice need to do?

Doctor needs to complete a doctor’s worksheet which will consist of:

  • Name and Date that the patient was seen
  • Provide the tariff codes for procedures, material and consultations which were rendered
  • Supply a signed Employer’s Report of accident and ensure the following: Company full name must be provided, Company registration number, Correct date of accident, Complete description of how the accident took place,
  • Doctor must complete a First, Progress, Final and Resumption report on date of consultations
  • Supply copies of the above mentioned documents to Better Practice Management
  • If the patient was referred by another medical practitioner provide the details of the medical practitioner who referred the patient, the practice number or a contact telephone number
  • Provide the claim number assigned to the case (must’ve been previously registered by the Employer)
  • Provide Better Practice Management with all documentation received from the Workman’s compensation commissioner relating to the various claims and notification of acceptance of the claims
  • Provide Better Practice Management with all payment remittances received as payment will be made directly to the practice

Billing is based on actual debt recovery of the WCA Claims and administration per individual practice and will be 20% of the claim value.

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