We are CompMed Analysis.

CompMed Analysis offers a full-service solution to help hospitals & healthcare systems resolve and manage the complexities involved with the processing of their Workers’ Compensation claims of the patients they serve.

The Challenge

Healthcare facilities are facing the ongoing changes involved with the Affordable Care Act paired with the burden of declining hospital reimbursement with Medicare and Medicaid.

CompMed has helped hospitals recover over $1 billion dollars in revenue deemed unrecoverable.

Workers' Compensation cases account for 3-5% of all hospital visits.

CompMed has helped increase Workers' Compensation collections within partner healthcare systems by 52%

Workers’ Compensation claims are often difficult and tedious to manage, ultimately capturing additional hospital resources in order to get these accounts paid properly. CompMed Analysis alleviates these concerns by managing the hospital’s Workers’ Compensation accounts so that your expert staff can stay focused on the bigger picture.

The Solution

Watch our short explainer video to understand how CompMed Analysis identifies lost dollars and helps our hospital partners resolve Workers’ Compensation cases of all types.

Reimbursement pressures continue to accelerate within healthcare systems. Our knowledgeable staff understands that Workers' Compensation payments can be difficult and time-consuming, often leading to revenue captured that is not worth the resources dedicated to solving these complex claims.

Our expert & clinical staff are specifically trained in the following services in order to obtain faster & higher levels of reimbursement.

  • Registration & Front End

    We identify the correct payer for each Workers' Compensation visit & register the insurance properly in order for bills to drop correctly. Our Front End specialists can process your First Report of Injuries and have the training to report new injuries electronically with the Bureau of Workers' Compensation.

  • Clean Claims

    Through our streamlined process, our goal is to get as many Workers' Compensation visits into this category as possible. Although many obstacles are unavoidable, we work to identify those as early as possible to expedite your payments.

  • Coding & Billing

    The number one denial is with diagnosis codes. It occurs nearly 35% of the time with each submitted bill. Our team interfaces with the hospital billing and coding teams to assure compliance practices are closely adhered to with the goal of minimizing coding rework.

  • Authorization & Appeals

    Retro authorizations are time-consuming, however, very necessary in the Workers' Compensation industry. We have an on-staff clinical team which includes nurses, physician advisors, and legal counsel to reach out to the appropriate individual to get the issue addressed.

  • Denial Management

    Whether the bill was denied for allowances, date ranges, coding discrepancies, billing issues, or any other reason that may occur with your Workers' Compensation claims, our team takes a step-by-step approach through proven algorithms to identify and solve the problem.

  • Payment Review

    Once a payment has been posted, we carefully review the EOB to confirm all line items were paid properly in accordance with the fee schedule set in place by the Bureau of Workers' Compensation, other states' Workers' Compensation payers or the Department of Labor. Any zero and partial payments identified will continue to be worked until the bill is paid in full.

Our Process

Equipped with a complete understanding of the Ohio Workers' Compensation law, clinical care delivery and a profound knowledge of the healthcare system, we are able to offer a full-service solution to resolve each Workers' Compensation case in a timely manner to help the hospitals, as well as the patients.

Scheduling

The hospital coordinates all patient scheduling. When the account falls into the Workers' Compensation Financial Class, it is referred to CompMed.

Registration

CompMed staff reviews the account for payer and employer accuracy. We also confirm that the visit is due to a work-related incident.

Insurance Verification

CompMed staff reviews the payer fields to confirm the insurance is updated accurately and the claim number is added before the bill drops. This results in an increase in clean claims.

Charge Capture & CDM

Hospital team to catalog & apply charges for all services provided. We notify the hospital if there are any unique nuances, most often occurring with Department of Labor claims.

Medical Records Documentation

The hospital records and scans all medical records so that CompMed can provide necessary documentation to payers.

Coding Inpatient &
Outpatient

Hospital's coding team accurately codes inpatient & outpatient visits. We interface weekly with hospital coding teams for re-evaluation situations including CPT & ICD-9 codes.

Claim Generation & Submission

We work with the hospital to create a claim number for new injuries. We can also initiate the First Report of Injury process. We verify the claim number on follow-up visits & submit bills with documentation needed for payment.

3rd Party Follow-Up

We execute follow-up with all Workers' Compensation payers to obtain accurate payment in a timely manner. If denied, we re-bill & work with the commercial carrier to payment.

Payment Posting

After payment is posted by the hospital cash posting team, our staff reviews the EOB daily to ensure accurate payment was received. If EOB reveals a partial payment, we continue to work until full payment is posted.

Denial Management

When a bill is denied or partially paid, our expert team executes an approach using proven algorithms to identify and solve the problem in order to receive payment.

Appeals & Retro Authorization

We have an on-staff clinical team which includes nurses, physician advisors, and legal counsel to reach out to the appropriate individuals to get any authorization issues addressed.

Final Resolution

CompMed is dedicated to meticulously handling all denials correctly. After we have reviewed the EOB and determined the account was paid correctly, we close the account and deliver you a monthly report of these completed accounts.

Scheduling

Hospital

Registration

CompMed Analysis

Insurance Verification

CompMed Analysis

Charge Capture & CDM

Hospital

Med. Records Documentation

Hospital

Coding Inpatient & Outpatient

Hospital

Claim Generation & Submission

CompMed Analysis

3rd Party Follow-Up

CompMed Analysis

Payment Posting

Hospital

Denial Management

CompMed Analysis

Appeals & Retro Auth

CompMed Analysis

Final Resolution

CompMed Analysis

  • SchedulingHospital

    The hospital coordinates all patient scheduling. When the account falls into the Workers' Compensation Financial Class, it is referred to CompMed.

  • RegistrationCompMed Analysis

    CompMed staff reviews the account for payer and employer accuracy. We also confirm that the visit is due to a work-related incident.

  • Insurance VerificationCompMed Analysis

    CompMed staff reviews the payer fields to confirm the insurance is updated accurately and the claim number is added before the bill drops. This results in an increase in clean claims.

  • Charge Capture & CDMHospital

    All of these functions remain entirely within the hospital team to catalog and apply charges for all services provided to the patient. We notify hospital staff if there are any unique nuances most often occurring with the Department of Labor claims.

  • Med. Records DocumentationHospital

    The hospital records and scans all medical records so that CompMed can provide necessary documentation to payers.

  • Coding Inpatient & OutpatientHospital

    The hospital's coding department accurately codes both inpatient and outpatient visits based on coding guidelines. CompMed has a well-defined process to weekly interface with hospital coding team for re-evaluation situations including both ICD-9 codes and CPT codes.

  • Claim Generation & SubmissionCompMed Analysis

    CompMed works with the hospital to create a claim number for each new injury. By request, we can also work with the hospital to initiate the First Report of Injury for an additional fee. For follow-up visits, the correct claim number is verified that it is associated with the injury being billed and we submit all necessary bills and documentation needed for payment.

  • 3rd Party Follow-UpCompMed Analysis

    Our staff diligently executes follow-up with the Workers' Compensation payers, to include: state-funded Managed Care Organizations, Third Party Administrators, Employers and the Department of Labor to obtain accurate payments in a timely manner.

  • Payment PostingHospital

    After payment is posted by the hospital cash posting team, our staff reviews the EOB daily to ensure accurate payment was received. If EOB reveals a partial payment, we continue to work until full payment is posted.

  • Denial ManagementCompMed Analysis

    When a bill is deined or partially paid, our expert team executes an approach using proven algorithms to identify and solve the problem in order to receive payment.

  • Appeals & Retro AuthCompMed Analysis

    We have an on-staff clinical team which includes nurses, physician advisors, and legal counsel to reach out to the appropriate individuals to get any authorization issues addressed.

  • Final ResolutionCompMed Analysis

    CompMed is dedicated to meticulously handling all denials correctly. After we have reviewed the EOB and determined the account was paid correctly, we close the account and deliver you a monthly report of these completed accounts.

Meet Our Leadership Team

Each of our employees represent the spirit and mission of CompMed Analysis: committed, driven and acutely aware of the Workers' Compensation process and law. We go to great lengths to train our staff in all areas of Workers' Compensation resolution to ensure each account is handled in a timely & accurate manner.

Our skilled management team has extensive background in the clinical, analytical and litigation fields. We work as an extension of your team and collaborate to deliver the most desirable results for your hospital.

Testimonials

As our Workers' Compensation expert, our team at Parma has worked with CompMed Analysis for over 9 years. We rely on them to help unravel the complex cases from authorizations to coding. We can consistently count on them to perform in this specialized area to include DOL. They focus in this area and are truly experts in this field...
-Robert Parris

Director, Patient Financial Services

UH Parma Medical Center

I have hired CompMed Analysis for Workers’ Compensation claims processing and management in both large system facilities and community hospital roles. They consistently exceed expectations and interface with needed hospital operations for an accurate payer outcome. Could not be more satisfied...
-Kevin Theiss

Vice President, Revenue Cycle

Western Reserve Health System

Through the annual performance of CompMed Analysis, I have personally witnessed revenue recovery for the Workers’ Compensation payer in the millions…
-C. Michael Rutherford

Chief Financial Officer

Wake Forest Baptist Health

As the founding health system for CompMed Analysis, we cannot say enough about their perseverance and knowledge of the Workers' Compensation Payer and what it takes to obtain a correct claim resolution...
-Thomas J. Strauss

President & CEO (retired)

Summa Health System

Robert Parris

Director, Patient Financial Services

UH Parma Medical Center

Kevin Theiss

Vice President, Revenue Cycle

Western Reserve Health System

C. Michael Rutherford

Chief Financial Officer

Wake Forest Baptist Health

Thomas J. Strauss

President & CEO (retired)

Summa Health System

News & Events

Emily Boies

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Niraj Patel

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Sherrie Bearden

CompMed Analysis President Selected as HFMA Guest Speaker

October 1, 2014

CompMed Analysis Founder & President, Sherrie Bearden, was selected to present at the Healthcare Financial Management Association (HFMA) Southwest Ohio chapter as part of their topical “Road Show” series to discuss the complexities involved with Workers’ Compensation claims.

The theme, “Unravelling Complex Cases: A Hospital Guide to Simplify Your Workers’ Compensation Claims,” was aimed at helping hospital teams better identify, understand, and avoid common pitfalls within complex Workers’ Compensation cases in order to obtain more clean claims as well as faster reimbursement.

Topics which were covered included:

• Alleviating the front end hiccups with FROI’s and Payers

• What is causality and how to work the accounts with diagnosis coding discrepancies

• Troubleshooting situations with Out-of-State claims

• Expectations and requirements of Workers’ Compensation Payers (MCO’S VS. SI)

• Common denials and mistakes to avoid with Workers’ Compensation claims

To learn more about CompMed Analysis and the vast array of Workers’ Compensation claims management services we provide, fill out our contact form or call us directly at 866-734-1936 to speak with our team.

Contact Us

Want to learn more about how CompMed Analysis can improve your AR and assist in the resolution of your Workers’ Compensation accounts? Please contact us, we’d love to setup a time to discuss.

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