Connectivity Simplified™
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Customized Services

WorkCompEDI offers numerous tools and services providing vigorous electronic connectivity to the workers compensation, automotive and personal injury/no-fault markets. For a single per-bill fee and a month-to-month contract (no setup fees, no monthly minimums, no postage add-on fees) submitters are able to partner with WorkCompEDI to reach the most robust electronic access points through a single vendor as a one-stop-shop eBilling partner to simplify connectivity and increase revenue streams.

Our direct submitter solutions – iCompEDI™, CompFax® & CompLink™ – allow users to transmit billing and supporting documentation to over 3,000+ electronic connections (2,000+ are directly connected to WorkCompEDI).

When electronic delivery is not available, WorkCompEDI fulfills its “all-Payor” capability by providing cost-effective print & mail services, which are enhanced by IntellignetMail Tracing & Tracking capabilities (similar to certified mail or UPS/FedEx package tracking abilities).

As the industry’s market leader, WorkCompEDI is dedicated to helping you meet your operational goals in a cost effective manner by providing automated products and services that allow your business to focus on growth and serving customers!

Submitter Solutions

Service Brochures

Automatic Secondary-Bill-Review™ (Appeals) Processing Service

States have passed mandates that require submitters to send secondary bill review (SBR) or appeals using a pre-defined process that requires the inclusion of additional documents and applications for consideration.

Large submitters are directly affected by this new requirement, as submitting SBR transactions is a large part of managing AR and cash flow. While most companies have manual workflows to handle the submission of SBR transactions with necessary supporting documentation the additional jurisdictional requirements stress those processes dramatically.

WorkCompEDI developed an automated way to efficiently process SBR transactions which has helped our clients save millions on potentially lost compensation for services rendered.

  • Submitters send EDI billing through WCEDI
  • Paper EOB/EOR transactions are sent to WCEDI (mail or scanned image), and converted to electronic records (835) through advanced OCR/KFI processes.
  • The iCompEDI® system automatically creates an electronic SBR from the bill record in the WCEDI clearinghouse system.
  • WorkCompEDI then transmits the SBR to the receiving party electronically (over 2,000+ EDI routes available today).

Manual Secondary-Bill-Review (Appeals) Processing Service

States have passed mandates that require submitters to send secondary bill review (SBR) or appeals using a pre-defined process that requires the inclusion of additional documents and applications for consideration.

Large and small submitters are equally affected by this new requirement. Most large companies have advanced workflow processes to handle the submission of SBR transactions with necessary supporting documentation (i.e. EOR, original bill and attachments, inclusion of necessary mandated forms) they feel have been incorrectly denied by a Payor. However, small and mid-sized submitters don’t have the same technology or resources to handle resubmitting SBR efficiently.

WorkCompEDI offers an efficient SBR processing service that automates the secondary bill review (SBR) appeals process and reduces a submitter’s A/R faster and in a more concise manner.

  • Submitters send EDI billing through WCEDI
  • Users log into iCompEDI®, identify the original bill in the history tab, select the bill, and click “create SBR transaction” button.
  • The iCompEDI® system automatically creates an electronic SBR from the bill record in the WCEDI clearinghouse system.
  • WorkCompEDI then transmits the SBR to the receiving party electronically (over 2,000+ EDI routes available today).

Direct-To-Mail™ (DTM) Service

Submitters are continuously tasked with responding to third-party requests for documentation regarding workers compensation cases and claims. This process is time consuming, costly and inefficient.

Large and small submitter resources are tasked with fulfilling this non-core process which does not work with existing billing workflows. Additionally, the receiving parties often do not have a means to accept the documentation electronically thereby rending the submitter with limited options except to print & mail the documentation.

WorkCompEDI developed a “non-structured document” fulfillment service which allows a submitter to transmit an image file to WCEDI for processing (EDI or print & mail). As this market expands, WCEDI continues to open electronic channels of delivery to its 2,900+ EDI billing routes, and actively seek the ability to connect electronically with law firms, state agencies and law enforcement entities.

  • Submitters send DTM transactions through their approved practice management software.
  • If the submitter’s PMS system is unable to send DTM transactions, the submitter can log into iCompEDI and upload the scanned images of the transaction directly to WCEDI.
  • WorkCompEDI then transmits the DTM transaction to the receiving party electronically.

Proof-Of-Service™

A large percentage of bills in work comp are denied by receiving companies due to timely filing reasons. When electronic connectivity does not exist, submitters are burdened with higher thresholds of proof whereby they are typically asked to prove they have sent bills with supporting attachments within a specific timeframe. This is difficult to do using sporadic and non-traceable USPS routes. Without over-costly certified mail channels to add the necessary documentation, proving bills were submitted within a stated timeline via print & mail is extremely difficult.

Submitters are taxed with re-submitting bills multiple times, delaying processing and payment.

WorkCompEDI has developed a streamlined “third party validation” service whereby billing is processed through the WCEDI clearinghouse and an attestment cover letter is generated and added to the bill as an attachment. This states to the receiving party that the submitter filed the respective bill and supporting attachments within time specific parameters through WorkCompEDI and we are ‘attesting’ to this claim.

  • Submitters send EDI billing through WCEDI
  • WCEDI generates and inserts a third-party attestment letter as an attachment to the bill that verifies to the receiver that the customer’s billing has been received and sent by WorkCompEDI within time specific parameters.
  • Billing is then processed according to WCEDI clearinghouse routing logic and sent electronically to over 3,000+ EDI routes, or if an electronic route does not exist, the transaction is printed & mailed (on paper via USPS 1st class mail).

IntelligentMail™ Tracing & Tracking Service

Submitters in the workers compensation industry are still submitting a large portion of their billing on paper (USPS mail). Without adding complex and costly ‘certified mail’ processes, once the billing is put into the USPS system, the submitter has no way of verifying if the transaction has been received by the designated third party, nor are they able to validate claims that the transaction sent did not contain all of the required documentation for processing.

A large portion of the industry sends out billing numerous times via regular mail (USPS) to ensure transactions are received and paid. This process bogs down a receiving party’s mailroom, creates duplicate processing responses, and adds delays to the billing cycles of the industry.

WorkCompEDI has developed an automated way to add a “tracing & tracking” bar code to transactions sent to WCEDI for processing, which a submitter can use to follow a transaction through the USPS system. Additional services by WorkCompEDI – like Proof-of-Service™ – will further attest to the receiving party that WCEDI has retained a copy of the documents sent and can verify for third parties what was sent (and when).

  • Submitters send EDI billing through WCEDI
  • WorkCompEDI transmits the transaction to the receiving party electronically (over 3,000+ EDI routes available today).
  • If the receiving party does not accept electronic transactions, WCEDI will print & mail the billing packet (USPS 1st Class), and attach its IntelligentMail™ Tracing & Tracking identifier so the packet can be traced through the USPS system (like certified mail).

Secondary-Party-Serving™ (SPS) Service

Submitters seek to send a copy (or copies) of bills to additional third parties after sending them for reimbursement to insurance carriers and bill review companies.

Submitters are required to generate multiple transactions in their billing system, or are required to process the information manually and send via USPS mail.

WorkCompEDI is able to provide multi-party serving fulfillment for clients who wish to transmit copies of their billing to additional party (or parties) through a single submission feed. Using the combined capabilities of our clearinghouse and our mailroom fulfilment divisions, we are able to receive a transaction feed from a submitter and complete the delivery of the billing between our 3,000+ electronic routes as well as fulfill a client’s request for printing and mailing copies to third parties.

  • Submitters send EDI billing through WCEDI
  • Additional recipient(s) are listed in the EDI bill sent to WCEDI in designated locations within the transaction
  • Billing is processed and sent to the receiving parties (WCEDI currently offers over 3,000+ electronic routes to receiving parties)