ComPro, Inc. Worker Benefit Fund Program processing services.
There are currently five programs funded by the Worker Benefit Fund: Retroactive Program (very old TTD benefits, Permanent Total Disability and Fatality claims), subsequent injuries for Preferred Workers(Preferred Worker Program), the Employer-at-Injury Program Reopened Claims Program (insurer voluntary and Board's Own Motion reopened claims) and the Handicapped Workers Program. (Technically, there is a Vocational Assistance Costs Program as well but it is largely inactive - only pre-1986 injuries with vocational rehabilitation services qualify).
Compensation benefits and sometimes medical costs paid on claims that qualify under these programs can be either fully or partly recovered by the self-insured employer or insurer. The monies must be requested in the proper amounts, within the allotted time frame and in the required format (as prescribed by WCD). ComPro, Inc. is currently handling many of these reimbursements for employers, third party administrators and insurers in a very cost effective manner.
How does the process work?
- Generally, ComPro, Inc. will conduct a brief initial review of each claim to gather/verify required information and establish that the claim qualifies for reimbursement under the various programs. An initial request for reimbursement can be made following this review. If the client so desires, ComPro, Inc. can also audit the claim to verify that past reimbursements have been made appropriately to maximize the use of the program.
- ComPro, Inc. will file reimbursement requests on a quarterly basis, as required by rule. Reimbursements for claims with ongoing expenses are also handled on a quarterly basis.
- For claims with ongoing expenses, the client can choose to either e-mail/fax the required information to ComPro, Inc. each quarter or have us continue to review the claims on site.
- Once filed, the client will receive a copy of the reimbursement request form indicating the amounts requested for each claim. Reimbursement checks are issued directly to the employer or insurer by the State of Oregon, usually within a few weeks of filing the request.
- ComPro, Inc. can also provide assistance with audit referrals produced by WCD field auditors in relation to reimbursements requested, accuracy of rates, etc.
- As an additional service, ComPro, Inc. can calculate October 1 Retroactive Program increases for each claim every year. We typically provide a calculation worksheet that indicates the amount of the claimant's monthly benefit and a letter that explains the increase to his/her benefit. The letter and worksheet can be mailed directly to the claimant by the client. This service meshes very well with the quarterly reimbursement requests as the same information is used for both services.
Why have ComPro, Inc. handle your reimbursement processing?
- The employees at ComPro, Inc. have been processing reimbursements for many years and can ensure the accuracy of the reimbursements/benefit increases. This also has the effect of ensuring the accuracy of benefits paid since we are essentially "monitoring" the payments for the client. Improved WCD field audit results usually follow.
- Utilizing ComPro, Inc. in handling reimbursements/calculation of benefit increases will save the client considerable staff time that can be allocated to other functions.
- ComPro, Inc.'s experience with all of the funds can be advantageous in maximizing recovery of claims costs. These reimbursements are essentially "free money" that certainly should not be overlooked.
- Because claims which qualify for relief under the various programs ocurr on an infrequent basis, your claims examiner may not have the time and/or be currently skilled to accurately process reimbursement requests. It is a major part of our business product so we make it a high priority to stay current and understand the use of the Programs.
How much does it cost to have ComPro "take care" of this function?
The reimbursement filing service is billed at $60 per claim, per quarter requested. The benefit increase calculation service is billed at $60 per claim, per year (the increase only happens once per year on October 1). If you would like to make arrangements for the service or just discuss details, call us at (503) 485-2344 or e-mail email@example.com