Workers' Compensation & Personal Injury Billing
Workers' Compensation & Personal Injury Billing from Soft Home Global costs $1,900 per seat per month. That is one full time trained person, forty hours a week, working United States business hours inside your own system. One seat, one month, cancel any time. On request. Nobody on our floor does that work yet. Ask, and we tell you in writing whether and when we can put a trained person in the seat, before you pay anything.
Workers' compensation and personal injury claims run on rules of their own: a claim number instead of a member ID, an adjuster and often a bill review vendor instead of a payer portal, authorization chased before the visit rather than after, and carrier reports that payment can be held over. In a shared billing queue these claims lose to the faster commercial work and quietly age past the state's filing and appeal deadlines until they are written off. This seat works nothing else.
Video transcript
- Workers' comp billing: works only injury claims.
- Captures the claim number and adjuster first.
- Chases authorization before the visit happens.
- Adjusters called on a schedule, not late.
What the seat actually does
- Claim set up at intake - claim number, date of injury, employer, carrier or third-party administrator and adjuster captured and verified before the first bill goes out.
- Authorization requested from the adjuster where the state or carrier requires it, chased on a set day, with every reference number and reply written into the claim note.
- Injury and progress reports drafted from what the provider has already documented, clinical sections left for the provider to complete, review and sign.
- Charges prepared on the forms, e-billing rules and fee schedule the claim's state applies, and every payment checked line by line against that schedule.
- Adjusters and bill review vendors called on a schedule rather than when the claim is already old, each call logged with the person reached, the reference and the next date.
- Personal injury balances tracked against the attorney, the letter of protection or the lien, with records requests and balance letters prepared for the practice to approve and send.
What it costs
$1,900
On request Nobody on our floor does that work yet. Ask, and we tell you in writing whether and when we can put a trained person in the seat, before you pay anything.
Per seat, per month, in US dollars. Full time, forty hours a week, on US hours — not per hour, not per claim, and never a share of your collections.
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How a seat starts
Every seat works from our office in Rawalpindi, Pakistan, on your hours, logged into your own system rather than ours. Some payer contracts and some state Medicaid programs restrict or require disclosure of offshore access — Medicare Advantage plans in particular require First Tier/Downstream/Related Entity oversight, which can mean disclosing us as a subcontractor — so check yours before placing a restricted queue on this seat. More on /security/.
You issue one named login. We sign the Business Associate Agreement before it is used. We agree the numbers you will judge the seat on, which you pick and you measure. Then we train for about a week on your workflow and the seat starts. Every Friday you get a written report of what was done, what the numbers were, and what went wrong.
Questions
How much does workers' compensation & personal injury billing cost?
$1,900 per seat per month. That is a full time person, forty hours a week, working United States business hours. Not per hour, not per claim, and not a percentage of what you collect. This seat is on request. Nobody on our floor does that work yet. Ask, and we tell you in writing whether and when we can put a trained person in the seat, before you pay anything.
Is there a minimum contract?
One seat for one month, cancellable with thirty days notice. There is no annual lock-in.
Do we have to change systems?
No. The work happens inside whatever you already use, through a named login you issue. We do not sell software and we do not route your data through anything of ours.
How quickly can a seat start?
This seat is on request. Nobody on our floor does that work yet. Ask, and we tell you in writing whether and when we can put a trained person in the seat, before you pay anything.
Can the seat decide what to code on an injury claim?
No. Code selection is a credentialed decision and it stays with your coder or the treating provider. The seat reads the note, abstracts what is documented, prepares the claim to the standard your coder sets, and raises a query when the documentation does not support what is being billed. Anything ambiguous goes back to the practice rather than being guessed at. If nobody in your practice owns that role today, we would rather say so up front than have an offshore seat quietly making coding calls it has no standing to make.
Can they actually get authorizations approved?
They can request it, chase it and document it. They cannot grant it, and they cannot make the clinical case for it. The seat builds the request from what the provider has already written, sends it to the adjuster or the carrier's utilization review vendor, calls until there is a decision, and records the reference, the person spoken to and the date. Where the reviewer wants clinical justification or a peer-to-peer call, that has to come from your clinician - and if your provider is slow to take those calls, the seat cannot fix it. What it removes is the chasing and the hold time, not the clinical judgment.
How is this different from putting injury claims in our normal billing queue?
In a shared queue, injury claims lose. They take longer per claim, they often need a phone call rather than a portal click, and a biller measured on volume clears the easy commercial work first. A dedicated seat has no easy work to retreat to. It works the list from the difficult end - oldest claim, hardest adjuster, missing report - and keeps a tracker showing every open claim, the last contact, the reference and the date it is due to be touched again. Where a bill is underpaid and the state has a fee dispute process, the seat assembles the packet and tracks the deadline; the filing itself goes out under your practice's name, not ours.
We only see a few work injuries a month. Is this worth it?
Probably not. This is one full-time person at $1,900 a month, and a seat only pays for itself when there is enough injury work to fill a day - a practice where these claims are a real line of business rather than an occasional one. Orthopedics, pain management, chiropractic, physical therapy and occupational medicine tend to have that volume; a general practice seeing the odd work injury usually does not. If your volume is thin, put the seat on your main accounts receivable and let it pick up the injury claims inside that work instead.
How does the arrangement actually work, and what access do you need?
One full-time person on your hours, working inside your practice management system, your clearinghouse and the carrier, adjuster and bill review portals you already use. Your data stays where it is. The price is $1,900 per seat per month, paid up front, one month minimum, thirty days' notice either way. You direct the work as you would direct an employee - your queues, your priorities, your escalation rules. HIPAA has no certification for anyone to hold, so treat any vendor claiming one carefully. For anything else — SOC 2, ISO 27001 — ask for the report, its date, its type and its scope, and we will answer with the paperwork rather than a slogan. Access is whatever you grant under your own agreements, and you can withdraw it the same day.
Next step
Ask whether we can staff a workers' compensation & personal injury billing seat
$1,900 a month once it is staffed. Nobody on our floor does that work yet. Ask, and we tell you in writing whether and when we can put a trained person in the seat, before you pay anything.
Or write to ops@softhomeglobal.com