Workers’ Compensation Bill Review and Claims Management Solutions

Mitchell’s full spectrum of workers’ compensation solutions and services combines industry-leading software with technology-enabled services to help provide better outcomes.

Mitchell Can Help You:

 

Maintain Medical, Fee Schedule and Regulatory Reporting Compliance

Mitchell helps our clients manage compliance with workers’ compensation regulations, including fee schedule and medical requirements and CMS and FROI/SROI reporting.

Medical and Fee Schedule Compliance

Mitchell employs a dedicated compliance team that not only follows the workers’ compensation legislative landscape but also helps to drive and inform its policies. Our compliance experts deliver regular industry updates to our Compliance Connection website. Mitchell delivers fee schedule data and other regulatory data updates to our software as needed.

Mitchell Regulatory Reporting Solution

Mitchell’s regulatory reporting solutions simplify the reporting process for our clients by providing a singular connection for state reporting and by including more than 10,000 mandatory and conditional edits. Our compliance team works directly with states on reporting requirement changes and monitors for updates. We provide multiple options to help our clients with state reporting:

Data Entry

Assemble, manage and submit the required information in compliance with jurisdictional regulations in our easy-to-use, secure web portal.

Import/Export

Eliminate manual data entry by exporting FROI/SROI data from the claims management system. Submit files for IAIABC releases in a single file format.

AutoTriggers

Reduce the manual work involved with EDI compliance processes by automatically exporting raw claims and letting AutoTriggers take care of the rest.

Manage Compliance

Review Medical Bills & Contain Costs

Mitchell provides flexible and customizable solutions to help our clients contain and manage workers' compensation costs.

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SmartAdvisor Medical Bill Review Platform

Mitchell’s industry leading medical bill review platform can be customized to our customers’ specific workflows to help them accomplish their unique business goals. The technology, supported by a highly sophisticated and Mitchell-owned rules engine, helps to drive consistency and accuracy in price for care. Additionally, our medical bill review clients have access to Mitchell Mosaic—a proprietary approach to sourcing and stacking PPO networks—and the dedicated teams and tools necessary to design and customize their workflows and outcomes.

Mitchell offers its medical bill review platform to its clients via one of three methods: licensed software, Technology Enabled Services or a hybrid model.

Technology Enabled Services

Free up time for adjusters to focus on high-value tasks and complex decision making by partnering with Mitchell’s Technology Enabled Services. The Technology Enabled Services team provides end-to-end business processing & specialty services with speed and accuracy, driving value to clients. Services include:

  • Data Capture Services
  • Document Management
  • Full Bill Processing
  • Certified Code Review
  • Mailroom Services
  • Quality Assurance
 

Our Technology Enabled Services team also offers additional services that add an additional layer of cost containment to the bill review process. These additional services include:

Mitchell AuditPro

Mitchell’s AuditPro bill auditing solution employs a unique blend of technology, data and expertise to detect billing errors, and validate and correct medical codes and charges against medical records for bill review pricing. The AuditPro solution addresses a wide range of bill types including professional and facility bills.

Mitchell Specialty Bill Review

Mitchell’s specialty bill review solution provides usual and customary pricing to help payors consistently pay a fair and reasonable price for out-of-network medical bills when fee schedule pricing does not exist.

Mitchell Negotiations Services

Mitchell organizes and surfaces facts that were gathered during investigation, liability assessment and injury evaluation to help adjusters efficiently build a clear negotiation strategy. Mitchell’s negotiation module is highly flexible and can integrate the following features with a claims management system.

 

Automate and Enhance Medical Management Programs

Help reduce the cost and time historically required for medical review on referrals and bills.

Enhance your organization’s medical management program and teams with Mitchell ReviewStat®, an intuitive web-based and highly automated workflow optimization solution built to facilitate and monitor the progress of cases for utilization review, peer review and case management.

Learn how the ReviewStat medical management software can help you realize greater efficiencies and increase productivity within your utilization review and case management teams.

Receive Bills and Submit Payments Electronically

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SmartBill

Mitchell's SmartBill solution processes electronic bills to help increase efficiency and drive savings for our clients. Mitchell understands the value of increasing eBill penetration and works directly with providers to encourage migration from paper to electronic billing.

SmartPay

Mitchell’s SmartPay solution offers end-to-end automated payment reconciliation and drives efficiencies in the payment process, and help reduce material and labor costs. Mitchell provides a unique, fully outsourced payment solution that operates using an opt-in model for providers and delivers payments via check, ACH or virtual card based on provider preference.

Streamline Payments

 

Assess Performance with Advanced Reporting and Analytics

Reveal custom and actionable program insights with robust tools.

Mitchell provides a variety of both standard and ad-hoc reports for our clients, including but not limited to:

  • SmartReports
  • ReportBuilder
  • SmartTracker Performance Dashboard
  • Provider Analysis Report
  • Industry Comparison Report
  • Provider Network Performance Report

Mitchell Claims Performance Consulting

Mitchell offers consulting services to help clients gain a deep understanding of how their current Mitchell product features can be leveraged to meet the demands of a dynamic market. Leveraging our rich database and reporting capabilities, our Claims Performance Consulting professionals use in-depth expertise to help clients identify untapped opportunities in their claims management processing as well as reveal custom, actionable insights and benchmark their results compared to the industry.

 

Want to learn more about Mitchell’s full suite of end-to-end casualty solutions?
Contact us here.

Insights on mPower by Mitchell

Read more about how integrated casualty solutions can help improve the claims process for insurers, third party administrators, state funds and other claims payors.

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The Power of Perspective: Seeing the Full Picture of a Claim

Having a comprehensive perspective into all of the events and details surrounding a claim is powerful—since good data often provide actionable insights to drive better decision making in the claims process, and better decision making usually results in better outcomes that help restore lives.

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Using Integrated Solutions to Help Improve The Workers' Compensation Claim Process

From the moment an injury occurs, to the day an injured worker returns to work, the journey a workers’ compensation claim may take is complex, involving numerous parties and diverse jurisdictional requirements. Integrated solutions help deliver better outcomes for all stakeholders involved in the claim.

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The Power of Technology: Six Ways to Improve Casualty Claim Outcomes

Here are six tips for using technology effectively to simplify and improve casualty claim outcomes.

Read More >

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