HOME » Managing Third-Party Follow-Up: Workers’ Comp and Other Claims Case Study

Issues

Community did not have the resources to internally manage workers’compensation claims. Staff did not have the necessary expertise to successfully recover workers’ compensation revenue the organization was owed. Community was also in the process of going through a system conversion leading to a backlog in insurance follow-up.
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Answers

Community decided to partner with Convergent based on the solution provider’s expertise with difficult claims such as workers’ compensation. Convergent worked directly from Community’s billing system to follow up on workers’ compensation accounts and aged insurance accounts. Convergent provided onsite training for Community’s internal insurance follow-up staff.
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Outcomes

Convergent typically resolved 75–85% of workers’ compensation placements within 90 days. Over 2+ years, Convergent collected $16.7 million from workers’ compensation accounts for Community. Convergent also collected $19.2 million from aged insurance accounts.
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