Workers’ Compensation Case Study
Collaboration with Workers’ Comp Partner Resolves Inventory Backlog, Improves Collections
The COVID-19 pandemic has increased attention to “occupational illnesses,” and a broader range of jobs is now considered potentially dangerous.* Many states have passed legislation extending Workers’ Compensation benefits to employees who get the illness while on the job.** Hospitals and health systems should consider the potential long-term effects of these trends when evaluating their WC program.
The Challenge
A large academic medical center and health system in the Midwest had accumulated a backlog of Workers’ Compensation (WC) accounts that was becoming unmanageable through internal processes. Leadership pursued collaboration with a partner with dedicated WC resources capable of resolving the inventory backlog and managing the monthly influx of thousands of new placements.
The Solution
Elevate Patient Financial Solutions℠ implemented its WC program, working closely with the health system to prioritize inventory, realign operational teams for improved efficiency, and identify new opportunities for improvements to systems and processes. ElevatePFS provided trusted counsel on best practices because of its deep WC expertise and extensive experience with Epic clients. With a critical focus on aging inventory, ElevatePFS ensured maximum collections on any viable claims and quickly resolved non-viable inventory.
The Results
- In the first year, nearly $37 million was collected: $5.7 million came from aged, backlogged inventory – reimbursement that otherwise would have been lost, and an additional $32 million came from “new” inventory.
- Within the first two years, a total of almost $80 million was collected. And it’s worth noting that $23.6 million was from physician billing claims, a segment of inventory that typically doesn’t get as much attention or collection effort.
- In this timeframe, the overall volume and age of WC A/R inventory decreased significantly.
The Elevated Difference
Every member of the ElevatePFS team was fully engaged in the health system’s overall success, and it showed in several ways. ElevatePFS related previous experience redesigning Epic workflows, managing account balance write-offs, and sending patient balance contact letters to help the client make beneficial changes to its own methods. And as a courtesy, ElevatePFS reviewed and resolved accounts totaling $13 million in collections in addition to its original contract commitment.
Resources
* “COVID-19 and Workers’ Compensation: What You Need to Know – Frequently Asked Questions –UPDATE,” National Council on Compensation Insurance (NCCI), October 2020
**“Expansion of Workers’ Comp for COVID-19 Created Narrow Benefit in 6 States,” Insurance Journal, December 2020