An ever changing part of healthcare dynamics.
Originally, Workers’ Compensation was established as a trade off for employees agreeing to not take their employers to court when an injury occurred. The employer saw to their care and time off work, and the employee tried to recuperate and return to work quickly.
Today, Workers’ Compensation is affected by State and Federal regulatory law, overseen many times by state Labor Departments or in some cases Department of Insurance, who have established (in 44 states and DC) State Workers’ Compensation Fee Schedules in an attempt to contain the cost. These claims are administered through Insurance Carriers (as an insured policy or self insured funds being administered on behalf of a self-insured-employer).
Often Workers’ Compensation claims are processed through software applications being used in bill review shops, and paid via Third Party Administrators. The Result makes the Workers’ Compensation side of healthcare very difficult to navigate. Understanding the dynamics of workers’ compensation is no small task, and you need a partner with understanding to assist your efforts.
National PPO Network
Despite an employer’s best efforts to provide a safe work environment, workplace mishaps happen. When an incident occurs where health care is necessary, finding affordable and accessible care can be a challenge.
Some states have special network programs like Texas' HCNs and California's MPNs. Navigating the intricacies of these program's guidelines can be a daunting task. Prime Health Services is here to help!
More than a PPO network, Prime Health Services offers specialty networks that allow a client tailored access to specific health care needs, such as surgery, hearing, independent medical reviews, and more.
Whether for a specific client need or an individual bill, we have staff ready to perform negotiations within a 72 business hour period. Our experience with this process enables us to achieve the maximum amount of savings.
PRIMEoutcomes is an automated health care assessment that measures patient outcomes in certain neuromusculoskeletal injuries or diseases, creates a visual trending report, and aids providers in creating and monitoring treatment plans for effectiveness.
Medical Bill Review
Our Bill Review Program offers an innovative approach to delivering maximum savings on medical claims. Our technology continues to be at the forefront of the industry which allows our clients to achieve results beyond industry expectations.
Prime Health Services is here to help.
Prime Health Services offers our clients a unique understanding of the industry in order to help navigate through all these relationships. At Prime Health Services, we are never content with doing things the way they have always been done! Innovation is a driving factor to doing things better.
Consequently, Prime Health Services offers our clients speed of processing in a cloud-driven environment, accessing the best directly contracted relationships and partner-networks in a matrix offered to bring our clients the best coverage and best savings possible. Prime Health Services offers the most unique cost containment solutions available in the industry!