During my many years of consulting chiropractic offices and working with their outstanding receivables, I found that most of my clients had something in common.  Many of their outstanding receivable accounts fell into the category of "Workers Compensation."  I also found that the reasons why my clients were experiencing problems collecting on their Workers' Compensation patients were very similar across the board.  The necessary initial investigative and research process that is required when treating a patient with a work-related injury was incomplete, sloppy or not performed at all.

A common trend that was most disturbing to me, as well as a nightmare to fix, was that many of these offices were gathering information for all possible insurances held by the patient (health, workers compensation) and submitting claims simultaneously to see "who would pay."  Another common problem I found, which resulted in many unpaid claims, was that the offices were documenting and diagnosing the work-related injury, but were filing the claims to the patient's health insurance, instead of gathering the information they needed to file the claims where they should have been filed - with the Workers' Compensation Insurance.  Upon receipt of the claims, the health insurance carrier would perform a "Coordination of Benefits" to determine who the responsible payer should be.  When the health insurance payer determined that the patient was being treated for a work-related injury (either from a report requested from the physician or the questionnaire sent to the patient), all claims were denied. 

When handled properly from the very beginning, obtaining fair and complete reimbursement for a patient being treated for a work-related injury should be relatively easy to accomplish.  The "ounce of prevention" I refer to equates to diligence in the initial stage of fact-finding and information-gathering when a patient first presents due to a work-related injury as well as a routine to follow up on unpaid claims.