Could a Workers Comp Insurance Audit Be Considered a Positive Way to Trim Costs?

Written by on 12/18/2017 1:02 AM in , , . It has 2 Comments.

Dreading your upcoming workers comp insurance audit? Don’t. Scrutinizing bills often works in the favor of employers, rooting out questionable billing practices and preventing overpayment.

How Could a Workers Comp Insurance Audit Help Your Business?
This crucial, yet frequently overlooked area of the claims process can identify common billing errors that cost you in medical expenses and an increased X-mod, such as:

- Wrong facility type/location (hospital vs. outpatient center)
- Services coded at a higher severity than reported.
- Line item charges for services/supplies that should have been packaged (at a lower rate).
- High implant markups over four-times provider cost.

A Key Element of Your Cost Containment Arsenal
Verifying each and every line item may seem tedious and unnecessary. However, accurate billing is the foundation of an accurate valuation and workers comp insurance cost savings.

What Does Ferreting Out these Inaccuracies Net?

Facility Type Verification: Jurisdiction-based rules result in different prices for the same procedure depending on facility. Accurate classification safeguards expenditures, reducing reconsiderations and inflated processing times and costs.

DRG Group Validation: The difference between one Diagnosis Related Group (DRG) tier and a higher one is substantial –$2,000 to $35,000 per code depending on provider reports/services, netting big savings on just a few bills.

Implant Charge Review: Clinical implant reviews prevent re-reviews due to exorbitant implant markups, saving money and preventing excess processing times.

Unbundled Items: Supplies like surgical trays and drugs are already bundled into procedures. Adding them as line items equates to double-billing for these items.

Get through your next workers comp insurance audit with ease. Take advantage of these and other tips from Minnesota Comp Advisor today.

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