Shedding Light on Auto Liability Claims and Workers’ Compensation Bills
Property and casualty (P&C) insurers, third-party administrators (TPAs), bill review companies and other organizations involved in determining costs associated with auto accidents and workers’ compensation cases seek a trusted, defensible source of cost information upon which all parties can agree. These businesses license FAIR Health’s FH® Benchmarks and FH® Custom Analytics as reference points for a broad array of functions, including:
- Processing workers’ compensation bills;
- Finding values for codes not included in Medicare-based workers’ compensation fee schedules, using our FH® Medicare GapFill PLUS product;
- Helping to resolve disputes and determine costs associated with injuries and illnesses for auto liability claims. Our reliable, trusted data can be used to value a settlement that helps avoid costly litigation;
- Calculating the “value of paid bills” using our FH® Allowed Benchmarks. This is often an important component of a settlement, used either for real expenses or as part of the calculation of pain and suffering damages (which also could be based on a multiple of FAIR Health’s medical cost benchmarks); and
- Licensing FH Custom Analytics that show trends by procedure type.
Benchmark information is available in multiple formats, including through FH® Online, spreadsheets or data tables that can be loaded to internal systems.
Informing the Decision to Litigate or Settle
In a challenge to the proposed reimbursement for treatment of an auto injury, a bill review company uses FAIR Health’s data to determine if the billed amount was in line with other charges or allowed amounts in the same specific geographic area for similar services. Using our data as a standard helps companies determine which challenges are worth the time and money to pursue through arbitration or litigation.