We specialize in maximizing revenue for our clients in Workers Compensation and Third Party Liability (TPL) accounts.
To reach our goal, we take a full-service approach with our clients. Starting with the foundation of an attorney-client protections and privileges, our relationship is fortified with ongoing account management and consultation. Our relationship begins before the initial account referral and extends through to bottom-line recovery and beyond:
- Revenue Enhancement
- Account Management Consulting
- Legal Representation & Recovery
Our revenue enhancement services can find monies in your closed accounts that others have missed. We are able to be successful where others have not because:
- We are a legal firm. We know workers’ compensation and civil liability laws, the dynamics of payment for medical services, and the litigation process.
- We have our own in-house information systems capabilities, as well as one of a very small number of state-certified, proprietary software applications, that allows us to integrate our legal and business know-how into our search for here-to-fore missed revenue.
- The combination of these two key aspects to our revenue enhancement work not only differentiates us from our competitors, it also gives us the ability to maximize recovery.
- We bear the entire administrative costs associated with account audits, account preparation, and account recovery. We also bear the legal costs associated with any litigation required to ensure revenue maximization.
- Our fees are contingent upon the amount of recovery, and our clients have found our contingency fees remarkably refreshing.
Account Management Consultation
Typically, less than 5% of a medical providers’ accounts are related to treatment provided to injured workers. Yet, management of these accounts can take up a disproportionate share of time and resources from busy staff whose time could be better spent elsewhere.
Just as we have successfully assisted clients such as the State of California’s Victims of Crime unit establish effective and efficient account management processes, we can assist your business office to do the same.
Our consulting services include:
- Process design and implementation for in-house management of workers’ compensation account recovery
- Review of and recommendations on current account management processes
- Education and training of staff on workers’ compensation laws as they directly pertain to medical service providers
Legal Representation & Recovery
In the best of all worlds, medical providers would be promptly and properly reimbursed for the services rendered to injured workers. Unfortunately, this is not always the case. Medical providers can find their services unpaid or underpaid for a number of reasons, including:
- Denial of payment, based on disputed injury or disputed treatment
- Underpayment, based on contract vs. fee schedule issues
- Underpayment, based on miscalculations of the fee schedule
- Nonpayment, without a legal basis for denial of payment
When a workers’ compensation carrier denies or refuses to make payment for treatment rendered to injured workers, the medical provider’s recourse is to adjudicate the matter before the Workers’ Compensation Appeals Board.
We are that uncommon firm that specializes in providing complete legal representation to medical service providers. Unlike some of our competitors, we treat all referred accounts under the assumption that they will be litigated. As such, over 90% of referred accounts are fully recovered according to the official medical fee schedule or the contract under which treatment was provided.
Our services include:
- Filing of all legal petitions, including the Application for Adjudication of Claim, where needed; liens; petitions for payment of penalties and interest; etc.
- Representation at all hearings, from settlement conferences to Lien Trials and Court of Appeal.
- Obtaining expert opinions and testimonies; conducting depositions of witnesses; etc., as warranted by the referred case and nature of the dispute.
As our services are contingency-based, all costs associated with adjudication and litigation are covered under our contingency fees.