IL Workers' Compensation Medical Benefit Details

Keep track of medical providers, document requests, and invoices by selecting the Medical and Benefits Details layout. The Medical and Benefits Details also includes balances and helpful reports generated from the information you enter on the Medicals tab.

Benefits

The Benefits section will allow you to enter the Average Weekly Wage and Disability details.

Medicals

• The Medicals tab is where your important medical provider information is stored. Additional medical providers can be added by selecting the Add another provider link on the left side of the overall totals.
• Service Start / End Dates, Initial Invoice Amounts, and Balances are automatically filled based on invoices entered below.
  • Select the check box on the far right of each medical provider to manually override these fields.
• By selecting a medical provider first and then selecting Document Requests, all document requests can be tracked under the medicals tab as well.
  • Additional notes can be added to each request by selecting the note.
• To add additional document requests, select the Add another document request link on the left side.
• There is a PI & WC – Global Document Request Report that makes it very easy to see which records are still outstanding. We also have a Medical Records Request Widget for staff to see only the records outstanding for matters where they are assigned as the Attorney Responsible, Person Assisting or tagged on the matter.
• Any invoices associated with a medical provider can be entered by selecting the medical provider and then expanding the Invoices section.
  • Service Start / End Dates, Initial Invoice Amount, and Balance will be totaled and added to the medical provider table.
  • The Adjustment section here is for tracking any adjustments between the medical provider and the insurance company. Your negotiation adjustment is tracked elsewhere.
  • To add multiple Payors, right click on the line item and choose Add Payor.
  • To add additional invoices, select the Add another invoice link on the left side.

Balances

The Balances section will allow you to enter Medical Balanced Owed, Claim Holders, and Additional Balances Owed.

Reports

Each matter includes helpful reports under the Medicals & Settlement Details, including:

• Medical Provider Summary Report: Medical provider, dates of service, initial invoice amount and final invoice amount (after adjustments due to insurance companies or Medicare).
• Medical Provider Summary Report (incl. contact information): Medical provider, address of provider, dates of service, initial invoice amount and final invoice amount (after adjustments due to insurance companies or Medicare).
• Medical Provider Summary Report - Chronological: Medical provider, dates of service, initial invoice amount and final invoice amount (after adjustments due to insurance companies or Medicare) arranged by dates of service.
• Medical Provider Outstanding Amounts Report: Medical provider, dates of service, initial invoice amount, final invoice amount (after adjustments due to insurance companies or Medicare) and balance due.
• Medical Provider Invoice Line Items Report: Detail of invoice line items entered separated by medical provider. Includes dates of service, invoice description, initial amount, insurance adjustment and final invoice amount.
• Medical Provider Invoice Line Items Report - Chronological: Detail of invoice line items entered for all medical providers, ordered by service start date. Includes which provider, dates of service, invoice description, initial amount, insurance adjustment and final invoice amount.
• Medical Provider Invoice Line Items Report with Payors: Detail of invoice line items entered grouped by medical provider. Includes dates of service, invoice description, initial amount, insurance adjustment, final invoice amount, payors, amount paid and balance due.
• Medical Provider Invoice Line Items Report with Payors - Chronological: Detail of invoice line items entered for all medical providers, ordered by service start date. Includes which provider, dates of service, invoice description, initial amount, insurance adjustment, final invoice amount, payors, amount paid and balance due.
• Medical Provider Documents Requested Report: Documents requested dates and received dates organized by medical provider.
• Medical Provider Documents Requested Report with Notes: Documents requested dates and received dates organized by medical provider including any internal notes.