medical billing for workers’ compensation providers

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MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

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Page 1: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Page 2: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

A Few Words About Westshore

Westshore Medical Billing is a full-service medical billing company. With the skill and up-to-the-minute knowledge of our Billing Team, we provide our clients with maximum, consistent income to their practices. As a part of our service, we offer our clients the technology to utilize Electronic Medical Records capability. This, in turn, essentially allows our clients to “go chartless”.

Westshore Lien Management provides Workers' Compensation AR collections, Lien Negotiation, and WCAB Representation for California Workers' Compensation claims. Our team of Work Comp collectors and litigators gets our providers paid the maximum possible amounts on their liens, in the fastest amount of time.

(877) 550-7812

Page 3: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Medical Billing and Collections for our clients.

We increase your profit. Pure and simple. We provide a stable, consistent, and professional billing service with up-to-the-

minute knowledge of billing and coding to generate the maximum income to your practice.

We have 22 years of experience SPECIALIZING in Workers’ Compensation billing and collections.

We take the time to understand both your practice and your vision for the future

of your business; and we commit to collaborating withyou to make that happen.

In short, it is about experience, follow through, and having both an interest in

and commitment to your financial success.

Page 4: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Westshore’s Billing Process

Page 5: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Workers’ Compensation Billing

Page 6: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

P2P Link: Electronic WC BillingThrough Westshore

(877) 550-7812

Page 7: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Electronic Workers’ Compensation Billing Through P2P Link:

• Payments arrive on average in 15 business days.

• Verification within 24 to 48 hours that your bills were received.

• Online claim number and date of injury verification .

Page 8: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

ADVANTAGE TO YOUof E-BILLING YOUR WORKERS’ COMP CLAIMS

• Claims and Reports acknowledged as received by Insurance Carrier.

• 45 Day “Clock” starts immediately.

• Electronic Verification of Receipt if litigation is later required.

Page 9: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

P2P Link – Technical Workflow Model

Page 10: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Westshore’s Follow-Up and Collections Of Your Claims

Page 11: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Review EOB’s and Appeal Improperly Paid Claims: Additional Reimbursements to You

Page 12: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

We Handle Your Denials:

• We professionally respond to:– MPN Disputes– UR Denials– AOE/COE Disputes– Coding, OMFS Issues– Medical Control Disputes– LC 4600 Disputes– Medical-Legal Issues

Page 13: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

If Insurance Refuses to Pay:

• We file an EDEX Inquiry on your claim.• We file your lien through EAMS• We frame the issues and lay the foundation

for Lien Resolution• We attend all required WCAB Hearings on

your behalf.

Page 14: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

We File EDEX Inquiry and Case Watch

Page 15: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

We File Your Lien Electronically Through EAMS

Page 16: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Your Liens and Documentation are filed Electronically

Page 17: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

• As EAMS “E-Form Trial” Participants, we can request WCAB Hearings (DORs), and get an immediate Calendar date.

• That means, your liens get on calendar on average 3-6 months before anyone else’s.

The Litigation Advantage

Page 18: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

• Our collectors resolve your liens through:– Telephone negotiation

with Claims Examiner or Defense Attorney.

– Settlement Demands, Written Correspondence.

– Filing Declaration of Readiness To Proceed and requesting WCAB Lien Hearing.

The Maximum Recovery Of Your Liens in The Minimum Amount of Time.

Page 19: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

1. Review and Appeal Billing and Previous Payments

2. Research current Case Information through EDEX

3. Electronically File your liens through EAMS

4. Frame the issues, lay the foundation for recovery of your lien.

5. Pursue Collections via Telephone and Correspondence

6. Aggressively Litigate at WCAB

Lien Recovery Process

Page 20: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Maximum Recovery Through Skilled, Professional WCAB Lien Litigation

Page 21: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Management Reports:We Generate Any Statistical Reports You

Require, at Any Interval You Require.

Page 22: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Accountability, Reports

Page 23: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Westshore’s Technology

Page 24: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

$ EMR – Want to go chartless? Now you can. Westshore Medical Billing uses the latest Raintree billing software that utilizes the Electronic Medical Records. Fully Integrated Electronic Medical Records.

$ E-Billing for Workers’ Compensation Claims through P2P Link.

$ Access - Want to see the status of your billing accounts at 11:00 PM on a Sunday night? Now you can! We offer our clients access to our billing software 24-hours a day, 7-days a week. Access is quick and easy. You will never again have to wait to get up-to-date information on any of your billing accounts.

Page 25: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Raintree Systems Billing and Collections Software Available to you 24/7

Page 26: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Proprietary 2009 StoneRiver, Inc.

Page 27: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

• Go to www.westshorenet.com/contact.htm and complete inquiry form.

• Or call us at (916) 783-7400 for free quote.

Getting Started…

Page 28: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

• Tell us a little about your Practice.–Your Specialty–Your Volume of Monthly Billing–Whether you also need AR Collections–Any Special Circumstances

Next…

Page 29: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

• With Information you have given us we will:– Give you a quote for Billing if you are interested– Let you know our Fees for Collections of your AR

and WCAB Representation.• Our Collections Fees will always be on

Contingency, that is, a percentage of the amount we collect for you.

Westshore Lien Management (877) 550-7812

We’ll Provide a Free Quote

Page 30: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

• Our Team will facilitate transition of your accounts.

• You will be given Total Access to our Billing

Collections Software

• We’ll minimize any disruption in Cash Flow.

• Deposit Checks to Your Business Account

• Frequent Reporting To You.

We’ll Make The Transition Painless:

Page 31: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

• “I can honestly say Westshore is the reason I am still in business…” E.S. Pittsburgh, CA

• “Finally my billing is effortless, my income consistent, and I feel confident that Westshore can handle any problem that might arise.” C.F. San Francisco

• “Westshore’s hard work and ‘thinking outside the box’ attitude has resulted in the collections of what would otherwise be written-off claims.” P.K. Riverside.

What Our Clients Say About Us:

Page 32: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

OUR COMMITMENT TO YOU:

To Provide You With an Experienced, Organized and Professional Billing Service.

To Research, Code, Authorize and Submit Your Claims properly so that

We get you the maximum dollar for every service you provide.

You be the doctor. We will get you paid.

Page 33: MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Westshore Medical Billing, Inc.Westshore Lien Management

(877) 550-7812www.westshorenet.com

Call us Today!