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Mitchell’s full spectrum of workers’ compensation solutions and services combines industry-leading software with technology-enabled services to help provide better outcomes.
Enhance Medical Management
Navigate Medical Claims
Process Bills Electronically
Mitchell helps our clients manage compliance with workers’ compensation regulations, including fee schedule and medical requirements and CMS and FROI/SROI reporting.
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’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:
Assemble, manage and submit the required information in compliance with jurisdictional regulations in our easy-to-use, secure web portal.
Eliminate manual data entry by exporting FROI/SROI data from the claims management system. Submit ﬁles for IAIABC releases in a single ﬁle format.
Reduce the manual work involved with EDI compliance processes by automatically exporting raw claims and letting AutoTriggers take care of the rest.
Mitchell provides flexible and customizable solutions to help our clients contain and manage workers' compensation costs.
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.
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:
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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’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’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 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.
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.
Realize Greater Efficiencies
Get your injured workers back to health, safely and quickly while maintaining costs.
Some of our services include:
Mitchell’s independent internal review and workers’ compensation utilization management programs are accredited by URAC, an independent nonprofit organization.
*In accordance with the California state laws and regulations, you can view Mitchell’s California Utilization Review plan here.
For more information, including a comprehensive list of our clinical services offerings, please visit genexservices.com.
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.
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.
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:
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.
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First Party Auto Casualty Solutions
Third Party Liability Solutions
Workers' Comp Solutions
Read more about how integrated casualty solutions can help improve the claims process for insurers, third party administrators, state funds and other claims payors.
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.
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.
Here are six tips for using technology effectively to simplify and improve casualty claim outcomes.
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