OVER 60 YEARS
We are proud to offer top
notch claim resolution service.
We provide compassion for
the patient, employer, staff,
and insurance carriers. We are
the last point of contact for
the patient, employer, or
insurance carrier so we strive
to build a loyal and trusting
relationship.
Claim Solutions started developing a claim resolution
process in late 2005. This process was designed to provide
healthcare organizations with a solution to the industry
wide problem of aging accounts receivables. By
concentrating our efforts in two specific areas, it allowed us
to streamline our processes, develop relationships with
payers and receivers, and lower costs to providers. In many
cases, Claim Solutions can solve these problems for less
than one-third of the current cost and dramatically reduce
AR in both of these buckets.
CLAIM SOLUTIONS, LLC
AREAS WE TARGET
Department of Labor/OWCP
Unethical Repricing Companies
Railroad
State & Local Employees
Occupational Accidents
Overturning Denial
Ethics is a critical issue in pricing because ethics and legality are not
synonyms; an unethical price is not always an illegal price.
The Office of Workers’ Compensation Programs administers four
major disability compensation programs which provide wage
replacement benefits, medical treatment, vocational rehabilitation
and other benefits to certain workers or their dependents who
experience work-related injury or occupational disease.
An occupational accident is an accident that people suffer at work. It
is an occurence that the victim had not planned or expected. An
occupational accident may also be an act of violence in connection
with or arising out of work.
Each division will have different procedures to follow for an injury to
an employee. Specific contracts and networks are to be notified with
the proper documentation for the injury.
Most employees are covered by workers’ compensation if they are
injured on the job. Those who work in the railroad industry,
however, have different requirements and benefits outside of the
workers’ compensation laws… FELA is a federal system that is
allocated to railroad employees and their families.
Reconsideration requests are processed on the denied claims per
the insurance carrier’s procedures. Claims are denied in error by the
insurance carriers.
CONTACT US
MEMBERS OF:
COMBINED
WHAT WE DO
•
Free audit of accounts: current AR or Adjusted Balances
with AR at zero balance
•
Only charge for what is collected
•
Structured around KPI's
•
Full time Resources for customer service follow up
•
We have established relationships with the States
Division of Workers' Compensation, third party
repricing companies, insurance carrier, and employers.
•
Ongoing team training and development to provide
specialized knowledge that is shared with client.
•
Specialize with claims dealing with the Department of
Labor, Occupation Accident, Railroad and Out of
Network claims
•
Correspondence Management
We work with healthcare provider organizations across the
country to help them process Commercial, Liability and
Workers’ Compensation claims to ensure they are properly
reimbursed via a proven healthcare revenue recovery
process. These complex claims, which oftentimes go
uncollected, represent as much as 5% of a provider’s
organizations revenue.
Because receivables are meant to be received, not written off.
Because receivables are meant to be received, not written off.
TURN YOUR AGING
WORKERS’ COMPENSATION
CLAIMS INTO CASH!
•
Reallocation of Staff
•
Minimize Collection Costs
•
Reduce AR
•
Lower Bad Debt
EXPERIENCE
Department of Labor/OWCP
Railroad
Unethical Repricing Companies
State & Local Employees
Occupational Accidents
Overturning Denials
Our team is ready to work together to create
game-changing experiences. Whether you have a
question about starting the onboarding process,
pricing, or trials, our team is ready to answer all
your questions.