Stop treating body parts the claim does not cover
A workers' comp referral comes in. Someone logs into the carrier or TPA portal, confirms the claim is open, finds out who the adjuster is this week, and checks which body parts and procedures are authorized. If the portal is unclear, they call.
Skip a step and the visit happens against a claim that does not cover it. A shoulder gets treated on a claim that only covers the lumbar spine, and the bill is written off.
Track carriers, adjusters, and body parts on every claim
Every carrier has its own portal
Sedgwick, Gallagher Bassett, CorVel, and the rest each work differently.
Adjusters change
The contact on the referral is often not the person handling the claim today.
Authorization is body part specific
A visit outside the authorized body parts goes unpaid.
Let agents verify every claim before anyone schedules
Clicks handles
- Verifies the claim in the carrier or TPA portal
- Identifies the current adjuster and contact details
- Confirms authorized body parts and procedures
- Flags mismatches between the referral and the claim before scheduling
- Writes the details into the EHR and updates adjusters and employers
Your team keeps
- Disputes with the carrier
- Peer-to-peer reviews
- Treatment plan decisions