No eligibility checks. No member cards. Claim numbers, authorizations, state fee schedules, paper and fax that are still legal, and one payer check that covers a dozen claimants. Generic medical billing software can't model any of that. Med Claims Pro was built on it.
There is no insurance card — there's a claim number and an allowance decision. Every entry, document, and payment in Med Claims Pro hangs off the claim, the way adjusters and payers think.
WC reimbursement comes from state fee schedules that change on state timelines. Rates in Med Claims Pro carry effective dates — new schedules arrive as updates and history stays intact for audits.
WC payers demand documentation with every bill. Your weekly narrative logs generate from the same entries as the forms — they can never disagree.
Per-patient posting can't model a carrier check that spans twelve claimants. Our Record-a-Check screen allocates one check across every bill it covers, with overpay protection and automatic short-pay flags.
In most states paper and fax remain fully legal and widely used. Forms generate ready to send, and fax integration keeps transmission receipts filed per client — your timely-filing evidence.
Underpayments aren't courtesy appeals — they're formal state processes with hard deadlines. Short-pays get flagged with balances and original forms preserved, ready for the rebill or dispute your state requires.
General platforms route everything through one health clearinghouse — which routinely fails in WC, where each administrator designates its own. We generate payer-correct forms for the channels that actually work today.
Most small WC providers weigh software against a billing service at 4–9% of collections. At $15,000/month in billings, a 6% service costs $900 every month. Med Claims Pro Professional is $299 — and the workflow, the documents, and the follow-up knowledge stay in your practice. See pricing.
Both, with ancillary first: vocational rehab counselors, nurse case managers, and other professionals who bill time against authorizations on the CMS-1500. Treating practices with heavy WC caseloads use the same pipeline.
No — because workers' comp has no eligibility to check. Coverage lives in the claim and its allowed conditions. That's exactly why group-health software feels wrong for WC work.
Yes. Payers are configurable — carriers, TPAs (Harborview Claims, Summit Claims Partners, Larkfield TPA, Crossbridge Claims), state funds, and Ohio's MCOs — each with its own form template and delivery details.
Starter is $10/month (form generation), Professional is $299/month (the full automation), Enterprise is $499/month + $99 per additional billing user. Yearly saves 30%. Details and free trial.