CompDirect is EnableComp’s day‐one outsourcing program for all your Workers’ Comp claims. Our proprietary contract management software, repricing and payer pathway tools allow us to deliver your bills to the right payer, get them paid timely and ensure that you get the maximum amount you’re entitled to. Outsourcing your Workers’ Comp will accelerate your cash flow cycle, improve your reimbursement yield and free up valuable hospital collection resources.
Here are the cornerstones of our program:
- Payer verification: We use our proprietary tools to make sure your bills go to the right place the first time. Our experience has shown that the large majority of Workers’ Comp hospital bills are initially sent to the wrong place.
- Bill pre‐packaging: Workers’ Comp payers often require significant supporting documentation to approve bills for payment. We match the bills with medical records, itemized statements, implant invoices and analysis prior to sending to the payer.
- Electronic billing: EnableComp has plug and play solutions with claims clearinghouses that accommodate electronic submission of attachments together with the bill. Use of E-billing typically improves days-to-pay significantly over paper bill submissions.
- Persistent telephone follow‐up: Workers’ Comp payers simply will not pay most hospital bills by paper bill submissions alone. We provide aggressive telephone follow‐up beginning as soon as seven days after bills are submitted.
- Thorough payment review: To ensure proper payment, all EOBs must be reviewed and amounts compared on a line‐item level. Our proprietary tools allow our Revenue Specialists to efficiently identify and appeal virtually all underpaid items.
The CompDirect program also offers these valuable features:
- Denial management: We quickly identify claims that are denied as not related to a work injury and provide the documentation necessary for the hospital to promptly pursue reimbursement from the patient or their health insurer.
- Front‐end contractual adjustments: Our contract management and repricing software allows us to identify state fee schedule and PPO contractual adjustments as soon as your data is passed to us. We return contractual adjustment amounts to you so that your trial balance can reflect actual amounts due within a few days of billing.
- Policy Advisement Group: The Managed Care department provides subject matter expertise for client hospitals for a variety of topics such as regulatory policies, contract management, and payer behavior. The team serves as the liaison between EnableComp and State Government and ensures compliance with reimbursement law.