Posted by Dan Schulte
This blog is the first of a two-part series covering the ever-evolving workers’ comp landscape for both providers and payers. This blog represents the provider perspective, and Part Two will focus on the service scope from a payer point of view.
One of the staples of reality TV over the last few years has been shows about people who do difficult, dangerous, and dirty jobs that most of us wouldn’t dream of doing. “Dirty Jobs,” “Deadliest Catch,” “Ice Road Truckers,” and others make most of us glad that someone else is doing it.
If they ever add “World’s Most Aggravating Jobs” to the mix, one that you can bet will be on the list is working with workers’ compensation claims. Just ask anyone who has to do it on a semi-regular basis.
Make no mistake: workers’ comp is a wonderful safety net for employees and employers. Prior to its introduction between the two Roosevelts (Teddy and Franklin) if workers got hurt on the job and required expensive medical care, their primary option for compensation was to sue their employers. No explanation is needed on why that wasn’t good for anyone. Workers’ comp avoids that unpleasantness.
Yet while it sounds simple and straightforward in theory, in practice workers’ comp is anything but. Instead it presents a Byzantine set of rules, regulations, and requirements that appear to be designed to ensure claims are rejected and providers are penalized for not performing up to standards.
For providers , however, it can be a nightmare, with so many rules and processes that must be followed to the letter, and so many resources required to manage the program, that by the time it’s all said and done, providers might end up actually losing money on the claims. It is why more and more providers are beginning to turn over all of their workers’ comp business processing to outside organizations that focus on this very specialized area of insurance.
Here are some of the many reasons you may want to consider doing the same.
The bottom line is that there is a lot of work (and expertise) required to ensure impediments to reimbursement from workers’ comp claims are removed and no money is left on the table. The ratio of volume to value makes it difficult to justify attempting to manage it all internally.
A good business process outsourcing (BPO) partner that works with workers’ comp all day, every day, will have the knowledge and procedures in place to ensure every statute is met, every contingency is covered, and everything is exactly as it needs to be, removing the bottlenecks to reduce the costs and improve revenue flow.
Even the most aggravating of jobs must be done. But they don’t have to be done internally. By moving workers’ comp claims and collections to a BPO partner, you can minimize problems for the organization as well as free up internal resources for more meaningful work.
Publish Date: April 20, 2016 5:00 AM
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