This is the first in an occasional series dedicated to nitty-gritty billing tips for workers’ comp; the kind of details that, if taken care of, will make life easier for both billers and claims administrators. We’re talking down in the trenches stuff, so expect practical--and sometimes unbelievably detailed--advice. I promise these pro tips will help.
My last post mentioned claim number patterns for Chubb and Gallagher Bassett. Following up on that, I thought I’d share a technique that we use here at DaisyBill to help ensure that submissions get accepted the first time. When our customers select a claims administrator for an injury in DaisyBill, we display any known claim number patterns for that claims administrator.
Why is a claim number pattern important? Claims administrators deal with a ton of claims and even more details. The easier providers make it for claims administrators, the better the chances of any particular bill being paid.
When a claims administrator matches the bill’s claim number to the patient's claim on file with the claims administrator, it helps if the claim numbers match exactly. This means not only numbers and letters, but also formats. Following the correct claim number pattern, without omitting any digits or dashes, means:
- bills have a higher chance of being matched quickly and smoothly
- reductions in the occurrence of rejections (the bill is returned to the provider, unprocessed)
- reductions in the number of “lost” bills because the claim number didn’t match
For example, Liberty Mutual’s pattern is typically WC###-A#####. WC608-A12345 matches this pattern, while W608-1245 does not.
If you’re a provider who is not a DaisyBiller, you may want to start noting claim number patterns and writing them down. If you’re a claims administrator, make sure providers know your most common patterns and with which type of claims they are associated.
Note: Bills with more than one claim number have a high rate of rejection because claims administrators have difficulty matching them to claim files. We highly recommend submitting bills with a single claim number. If a provider has a claim with more than one associated claim number, it’s a good idea to call the claims admin to ask which number is preferable.