Revenue Cycle Management Tips For Occupational Medicine Clinics

November 21st, 2017 /
Kristen Nehk
/ 4 Min Read


As a medical practitioner in Occupational and Environmental Health, your efforts are dedicated to the treatment and prevention of illness and injury in the workplace, which leads to increased productivity among workers.

Due to the high volume of patients seen, Occupational Medicine clinics have a unique set of challenges related to medical billing and revenue cycle management (RCM). For example, the Workers’ Compensation ACT requires authorizations and approvals before seeing the patient, and that can potentially limit the amount of treatment delivered. Additionally, Workers’ Compensation codes used for filing claims with insurance carriers vary from state to state.

Healthcare Revenue Cycle Management Market size exceeded USD 110 billion in 2021 and is expected to witness over 12.7% CAGR from 2022 to 2028. The HRCM market is anticipated to grow exponentially owing to the increasing patient admissions and growing healthcare expenditures.

Occupational medicine clinics can easily lose track of their employer invoicing due to their high volume and the attention required to manage what the clinic is being paid relative to how many employee patients they have seen.

Let’s take an in-depth look at some of the RCM and medical billing-related concerns in Occupational Medicine, and how best to resolve them.

Worker’s Compensation and Employer Invoicing

As mentioned above, Workers’ Compensation requires that you submit a Request For Authorization form before treating a patient’s work-related injury or illness, and without filing the form, the insurance carrier is not obligated to authorize treatment or procedure. Obtaining and filling out these forms can prevent the patient from being treated in a timely manner, and if the forms are filed improperly it can prevent you from receiving payment.

Employer invoicing can generate a healthy income for your practice, but can also become tedious and chaotic in short order. For example, some clinics file up to 1,000 employee invoices a month. Without an in-house biller, the tasks of billing these invoices, reconciling them, and then tracking them to ensure the invoices are paid, fall on the medical staff.

It’s important to have an organized system in place to keep track of the different regulatory requirements of Workers’ Compensation and medical billing in Occupational Medicine practices.

Revenue Cycle Management Services Simplify Occupational Medicine

Revenue Cycle Management Services Simplify Occupational Medicine

In addition to our Practice Management software, PrognoCIS delivers RCM Services including a highly trained, dedicated staff of certified medical billing professionals for all kinds of medical practices including Occupational Medicine. Our certified procedural coders (CPCs) review your Workers’ Compensation claims to make sure they are ready for submission and to increase the likelihood your claims will be accepted. You can even build custom claim scrubber checks to help you meet specific guidelines according to your state.

As a part of our revenue cycle management services, you can receive daily, monthly, and annual financial statements/reports that can help you to evaluate and focus the efforts of the medical staff. These reports are provided completely free of charge and include denials management, AR analysis.

PrognoCIS Occupational EHR Software and Employer Portal

Occupational EHR Software comes with a variety of forms for Occupational and Environmental Medicine, including OSHA and Workers’ Compensation. The EHR also delivers Occupational Medicine-specific workflows and content, which includes injury treatment, pre-employment physicals, medical surveillance, as well as instant testing for drug and alcohol use. Using PrognoCIS, you can also access patient records and prescribe medication remotely. Read our Occupational Medicine Case Study to see how PrognoCIS Occupational EHR can improve your practice’s workflow.

PrognoCIS Employer Portal helps your practice share the patient’s health information securely with their employer. In the portal, employers can view the following:

  • Patient visit documents
  • Invoices with claims
  • Outstanding payments

If you have any questions about getting our EHR software or RCM services for your practice, you can contact us or schedule a demo with one of our industry experts.

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