MEDICAL BILLING FOR WORKERS’ COMPENSATION PROVIDERS

Doctors: SB863 is HERE. Now more than ever you need a Billing Team

who will get you PAID.Westshore Medical Billing is a full-service medical billing company specializing in

California Workers’ Compensation claims. 2013 is a new world in Workers’ Comp with the passage of SB863. While there are enormous opportunities for those who can keep up with the changes there are also big challenges. Requests for Authorization, 2nd Bill Reviews, Independent Medical and Bill Reviews, are all new territory for providers. Westshore Medical Billing will get you through it.

Westshore Lien Management . We are the strong, committed and aggressive team you need to get you the highest possible reimbursement for your outstanding Accounts Receivables. The new Lien Activation Fees, changes in filing statutes and litigation regulations all require new strategies and focus

to get you PAID. We have it covered.

(877) 550-7812

Medical Billing and Collections for our clients.

We increase your profit. Pure and simple. We provide a stable, consistent, and professional billing service with up-to-the-

minute knowledge of billing and coding to generate the maximum income to your practice.

We have 25 years of experience SPECIALIZING in Workers’ Compensation billing and collections.

We take the time to understand both your practice and your vision for the future

of your business; and we commit to collaborating withyou to make that happen.

In short, it is about experience, follow through, and having both an interest in

and commitment to your financial success.

Do you ever wonder how much you are NOT getting paid?

Billing and Coding Inaccuracies: OMFS and CPT Coding errors result in chronic short pays. Failure to aggressively appeal downcoded items and denials within 90 days using Provider Request for 2 nd Bill Review. How many write

offs do you now have? Failure to properly document all of your services, ESPECIALLY Records Reviews and face-to-face time spent with patients. Lack of follow-through: how many claims never got to their destination?

Collection/Lien Deficiencies: Failure to file liens within the new SB863 statutes. Failure to resolve lien BEFORE you have to pay the Lien Activation Fees. Inability to frame the legal issues of your lien (ie. UR, MPN, Statutes, etc.) Failure to attend WCAB hearings, resulting in Notices of Intention to Dismiss your liens. Ineffective collections techniques.

How much income are you losing every month? (probably more than you think…)

• Have you been paid in full for your Records Reviews?• Are your PQME’s and AME’s being paid, and P&I

attached when late?• Are your surgical and ASC bills being paid correctly?• Were your downcoded and denied claims APPEALED

within the required 90 Days?• Have liens been filed on all your claims, within the

new statutes?

Grab a handful of your recent EOB’s and Denials:

Doctors: Workers’ Comp is complex—and never more so than now with the passage of SB863. Your billing team has to be top-knotch. Your

collections team has to be current, aggressive and ready to fight for your liens, all the way

through Trial, if necessary.

So… let’s get busy…

Westshore’s Billing Process

Workers’ Compensation Billing

P2P Link: Electronic WC BillingThrough Westshore

(877) 550-7812

Electronic Workers’ Compensation Billing Through P2P Link:

• Payments arrive on average in 15 business days.

• Verification within 24 to 48 hours that your bills were received.

• Online claim number and date of injury verification .

ADVANTAGE TO YOUof E-BILLING YOUR WORKERS’ COMP CLAIMS

• Claims and Reports acknowledged as received by Insurance Carrier.

• 45 Day “Clock” starts immediately.

• Electronic Verification of Receipt if litigation is later required.

P2P Link – Technical Workflow Model

Westshore’s Follow-Up and Collections Of Your Claims

Provider’s Request for Second Bill Review

We Handle Your Denials:

• We aggressively respond to:– MPN Disputes– UR Denials– AOE/COE Disputes– Coding, OMFS Issues– Medical Control Disputes– LC 4600 Disputes– Medical-Legal Issues

If Insurance Refuses to Pay:

• We file an EDEX Inquiry on your claim through CompData.

• We file your lien through EAMS• We frame the issues and lay the foundation

for Lien Resolution• We attend all required WCAB Hearings on

your behalf.

We File EDEX Inquiry and Case Watch

We File Your Lien Electronically Through EAMS

Your Liens and Documentation are filed Electronically

• As EAMS “E-Form Trial” Participants, we can request WCAB Hearings (DORs), and get an immediate Calendar date.

• That means, your liens get on calendar on average 3-6 months before anyone else’s.

The Litigation Advantage

• Our collectors resolve your liens through:– Telephone negotiation

with Claims Examiner or Defense Attorney.

– Settlement Demands, Written Correspondence.

– Filing Declaration of Readiness To Proceed and requesting WCAB Lien Hearing.

The Maximum Recovery Of Your Liens in The Minimum Amount of Time.

1. Review and Appeal Billing and Previous Payments

2. Research current Case Information through EDEX

3. Electronically File your liens through EAMS

4. Frame the issues, lay the foundation for recovery of your lien.

5. Pursue Collections via Telephone and Correspondence

6. Aggressively Litigate at WCAB

Lien Recovery Process

Maximum Recovery Through Skilled, Professional WCAB Lien Litigation

Management Reports:We Generate Any Statistical Reports You

Require, at Any Interval You Require.

Accountability, Reports

Westshore’s Technology

$ EMR – Want to go chartless? Now you can. Westshore Medical Billing uses the latest Raintree billing software that utilizes the Electronic Medical Records. Fully Integrated Electronic Medical Records.

$ E-Billing for Workers’ Compensation Claims through P2P Link.

$ Access - Want to see the status of your billing accounts at 11:00 PM on a Sunday night? Now you can! We offer our clients access to our billing software 24-hours a day, 7-days a week. Access is quick and easy. You will never again have to wait to get up-to-date information on any of your billing accounts.

Raintree Systems Billing and Collections Software Available to you 24/7

Proprietary 2009 StoneRiver, Inc.

• Go to www.westshorenet.com/contact.htm and complete inquiry form.

• Or call us at (916) 783-7400 for free quote.

Getting Started…

• Tell us a little about your Practice.–Your Specialty–Your Volume of Monthly Billing–Whether you also need AR Collections–Any Special Circumstances

Next…

• With Information you have given us we will:– Give you a quote for Billing if you are interested– Let you know our Fees for Collections of your AR

and WCAB Representation.• Our Collections Fees will always be on

Contingency, that is, a percentage of the amount we collect for you.

Westshore Lien Management (877) 550-7812

We’ll Provide a Free Quote

• Our Team will facilitate transition of your accounts.

• You will be given Total Access to our Billing

Collections Software

• We’ll minimize any disruption in Cash Flow.

• Deposit Checks to Your Business Account

• Frequent Reporting To You.

We’ll Make The Transition Painless:

• “I can honestly say Westshore is the reason I am still in business…” E.S. Pittsburgh, CA

• “Finally my billing is effortless, my income consistent, and I feel confident that Westshore can handle any problem that might arise.” C.F. San Francisco

• “Westshore’s hard work and ‘thinking outside the box’ attitude has resulted in the collections of what would otherwise be written-off claims.” P.K. Riverside.

What Our Clients Say About Us:

OUR COMMITMENT TO YOU:

To Provide You With an Experienced, Organized and Professional Billing Service.

To Research, Code, Authorize and Submit Your Claims properly so that

We get you the maximum dollar for every service you provide.

You be the doctor. We will get you paid.

Westshore Medical Billing, Inc.Westshore Lien Management

(877) 550-7812www.westshorenet.com

Call us Today!