Workers’ Compensation Claims

Workers’ Compensation Claims

Tasked with the complexities and time-consuming requirements of workers’ compensation claims, Kemberton’s deep-rooted proficiency alleviates added burdens as an ideal extension of the revenue cycle. We have highly experienced teams of specialists and innovative technology to navigate state rules and dispute resolution processes (including USDOL) that vastly improves workers’ compensation reimbursement in a more prompt and efficient manner.

Over 40% of patients do not know their Workers’ Comp coverage information

Challenges Kemberton Solves

  • Understanding the unique state-by-state complexities of resolving workers’ compensation claims and reporting requirements
  • Ensuring the employer has filed the "First Report of Work Injury" to their Workers' Compensation carrier
  • Submitting the workers' compensation claim to the wrong payer or third-party administrator (TPA), delaying reimbursement and risking a violation of state filing requirements
  • Continuous follow-up needed to ensure claims are being processed and that there are no issues causing a delay
  • Verifying reimbursements for accuracy once received and appealing underpayments

Our Workers’ Compensation Claims Process

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Step 1 – Identify WC Claims

Take direct electronic feeds of 837 files from providers and clearinghouse partners for claim submission, accelerating our ability to submit claims and turnaround cash.

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Step 2 – Confirm Employer & Carrier

Identify or confirm patient’s employer and workers’ compensation carrier as well as filing of accident claim.

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Step 3 – Submit WC Claim

Electronically bill and submit required documentation to workers’ compensation carrier.

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Step 4 – Follow Up

Follow-up with the workers’ compensation carrier on a regular basis, confirming all necessary documentation was received, until the provider receives payment.

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Step 5 – Reconcile

Reconcile payments received against expected reimbursement based on state specific rate table and
appeal underpayments.

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Step 6 – Report

Report to your specifications and provide notes scripting into your system as well as access to Kemberton’s system.

Our Results

Here are typical results realized by clients who outsource their workers’ compensation claims to Kemberton:

0 %

INCREASE IN WORKERS' COMPENSATION ACCOUNTS IDENTIFIED

0 %

INCREASE IN WORKERS' COMPENSATION SUCCESS RATES

0 %

INCREASE IN CASH PAYMENTS RECEIVED FOR WORKERS' COMPENSATION

Call us at 888.273.3303 or submit the form below

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Tennessee

6840 Carothers Parkway
Suite 150
Franklin, TN 37067

Patient Inquiries:
888.687.7580
info@kemberton.net

New Jersey

1040 Kings Highway 
Suite 501
Cherry Hill, NJ 08034

Patient Inquiries:  888.273.3303
info@kemberton.net

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With regards to any legal or accounting matters, the Company and Author recommend that the visitor seeks the advice of an appropriately qualified and licensed professional.

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