Workers Comp Software: Increase ROI and Accelerate Return to Work

The Workers’ Compensation system in most states is still not benefiting from the technological advances provided by the automation of their systems. As a result, Workers’ Compensation administrations all around the United States suffer friction and missed opportunities to reduce their costs.

 

In New York the city’s workers compensation costs increased by 109% since 2008. On October 21st, The New York Post informed that the average claim payout, which includes medical costs and lost wages, came up 57.4 percent in the period 2008-2017 (in 2008 was it $793 and in 2017 it came up to $1,381).

 

The migration to a digitized system that allows all the workers’ comp ecosystem stakeholders to access the same information immediately and implementation of an authorization system in real time that reduces medical costs, administrative time, resulting in reduced return to work days.

 

To improve administrative workflow the workers’ compensation administration need to customize their intervention strategy to improve speed and efficiency.

 

Through the elaboration of modules for each area of administration, information becomes orderly and accessible which in turn allows a more rigorous follow-up of the claims. Having a secure platform or an integrated solution within and existing program, the claims are reviewed in detail.

 

Conexia’s solution to this problem is the implementation of the modules from which you can expect the following:
Automate the administrative workflow (enrollment, eligibility, benefits administration, provider contracting, reimbursement, premium billing, medical management, care management, claims adjudication, customer service, and reporting) making all data available in real-time.

 

1. Via a secured platform, we integrate the whole WC program.

2. We verify compliance with state and national regulations to avoid penalties.

3. Audit module evaluates the services provided in relation to relevance, quality, quantity, costs and unjustified deviations to avoid over-invoicing.

4. We accelerate processing times by inserting alerts:

-to monitor the beginning and end of the affection,

-of time elapsed between the recording of the incident and the first performances,

-of time elapsed between evolution queries,

-of interruption of treatments.

5. We establish care protocols based on international medical guidelines, which allow us to define the optimal times of incapacity for work and the appropriate treatments for each pathology. This facilitates the incorporation of caps or business rules that contribute to a better organization and control of those affected.

6. Cost is dramatically reduced due to the elimination of paper filing, faxes and mistakes.

 

Contact us to learn more about reducing your costs with customized claims processing software:

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