Hospitals often lose out on revenue and face costly fines when dealing with workers’ compensation claims. Historically, claims are difficult to handle even when handled by trained billing staff that specializes in the niche. There are intricacies and loopholes that slow down the process and may create costly losses. The hospital staff hours wasted on such billing nightmares becomes costly, fines are often levied, and, ultimately, the hospital ends up losing money if everything is not precisely handled and implemented.
Here are a few frequent ways that the hospital billing staff might be making mistakes with compensation claims and costing the hospital valuable revenue.
- Commercial Versus Workers’ Compensation: It is not uncommon for hospital staff to become confused and accidentally bill commercial insurance instead of the workers’ compensation insurance. Such a situation does not only complicate things and slow down the entire process, but it is also illegal.
- Billing Errors: Incorrect billing the first time costs the hospital money and might even result in fines. Many times the hospital billing staff will first bill the patient’s private insurance company because the patient provided the insurance card at the time of treatment or admittance. The patient’s private insurance company will then deny the charges because it is a third party workers’ compensation claim and does not involve the private insurance company. The hospital staff must then re-bill the workers’ comp. The entire process can take months to resolve and sometimes litigation ensues. Ideally, the hospital staff needs to follow the required steps to determine if the case is a workers’ comp situation or not before any billing is made. This will save time, money, and prevent costly fines.
- Communication Breakdown: Often there is a communication breakdown between the hospital staff, the patient, and the claim process. If the staff in the hospital’s billing department does not take the time to verify the information obtained during the patient’s admittance procedures then the entire chain of communication collapses. This stalls the process and claim costs can dramatically escalate. In the worst case scenario, litigation will become a reality.
- Understanding the Laws: All states have their own unique set of laws that cover workers’ comp claims. Often the hospital’s billing staff lack the knowledge and training required to understand the state’s complicated legal system. If the required paperwork is not provided within a certain time frame, which varies by state, then the hospital will fail to get the money owed. This causes costly delays and often cuts into the hospital’s revenue.
Hospitals that want to avoid costly mistakes when it comes to handling workers’ comp claims should call in an experienced vendor such as the Midland Group. The Midland Group has the experience required to handle the complicated issues that often create roadblocks for typical hospital billing staff. Hiring the Midland Group to handle such notoriously difficult claims will help ensure that the hospital receives its revenue and does not suffer ongoing losses. The vendor’s professionals know the state’s particular laws, they always conduct a follow-up, and will effortlessly handle any disputes that might arise. The Midland Group acts as the ideal intermediary between the hospital and the workers’ comp insurer.
Please give the professionals at the Midland Group a call today.