What’s Included (Deliverables)
1. Intake Workflow Redesign & Staff Training
We rebuild and retrain your entire front-end system.
Updated intake scripts, forms, and documentation workflows
Coverage verification (NJ PIP, NY No-Fault, WC)
Employer validation, attorney info capture, police report workflows
1:1 and group training for front desk, auth team, and coordinators
Monitoring for accuracy, completeness, and adherence
2. Compliance & Timely Filing Infrastructure
We engineer a compliance-safe, audit-ready system.
State-specific filing timelines
Mandatory form tracking (C-4s, MG-2s, PR-2s, APNs, etc.)
Lien/AOB workflows
Documentation and disclosure protocols
Monthly compliance checks
3. Documentation, EMR Templates & Coding Integrity
Ensure each case is medically defensible and financially sound.
EMR templates for PI/WC/NF visits
Documentation alignment to mechanism of injury
E&M and procedural coding accuracy
Disability, work status, and MMI documentation
Weekly documentation audits with staff feedback
4. Denials, Arbitration & Appeal Optimization
We recover revenue many practices didn’t know they lost.
Denial pattern identification
Appeal templates (medical + legal)
Arbitration preparation (NJ PIP, NY NF)
Payout variance & interest calculation workflow
Ongoing monthly claims review
5. Attorney Collaboration Framework
We formalize communication with law firms.
Standard record sets
Narrative report templates
IME coordination workflows
Attorney communication scripts
Monthly joint-case review calls (optional)
6. Governance, Process Reinforcement & Monitoring (90 Days)
The true value—consistent reinforcement until the system sticks.
Weekly workflow compliance checks
Bi-weekly staff coaching meetings
Monthly leadership summary + analytics
Real-time escalation support
Continuous KPI monitoring
7. PI/WC/NF Performance Dashboard
A live operational performance tool.
Aging dashboards
Settlement-to-charge ratios
Denial trends
Payer-specific recovery analytics
Case velocity metrics
Timeline — 90 Days (3-Month Commitment)
Phase 1: Weeks 1–4
Assessment, workflow design, initial training, documentation fixes.
Phase 2: Weeks 5–8
Full implementation, denials cleanup, staff reinforcement.
Phase 3: Weeks 9–12
Governance, coaching, KPI tracking, arbitration prep, final optimization.