Workers' Compensation Revenue Cycle Management FAQs

Unified Health Services is a fully managed Workers' Compensation revenue cycle and medical billing company for healthcare providers. UHS manages defined work from front-end eligibility and authorization through billing, A/R, denials, appeals, payment reconciliation, and reporting.

UHS is a technology-enabled managed service, not a software license. UHS combines proprietary rules, automation, and specialized staff while remaining accountable for the work included in the agreement.

UHS supports health systems, hospitals, ambulatory surgery centers, specialty providers, and physician organizations. Scope can include institutional and professional claims across multiple facilities and systems.

Scope can include eligibility, benefits, employer and carrier validation, claim-number acquisition, authorization, billing, attachments, A/R follow-up, denials, appeals, expected-allowed review, lockbox, remittance conversion, reconciliation, and reporting.

Yes. Day 1 services address new claims before billing and through payment. Legacy A/R services focus on older inventory. Because the workflows and recovery profiles differ, the scopes are evaluated and priced separately.

Yes. UHS supports both institutional and professional Workers' Compensation claims, subject to each client's systems, entities, and contracted scope.

UHS can verify the employer, carrier, jurisdiction, benefits, claim information, and authorization requirements before billing. The objective is to prevent avoidable downstream denials and delays.

UHS uses ANSI X12 837 transactions where supported and manages required documentation through the accepted payer or jurisdiction channel. Electronic capability varies, so UHS monitors rejections and alternate submission requirements.

UHS applies jurisdiction, payer, TPA, bill-review, fee-schedule, filing, documentation, and dispute requirements within the managed workflow. Requirements and updates should be governed through documented operational review.

UHS identifies the denial or reduction, validates the expected reimbursement and applicable requirements, gathers supporting documentation, submits the appropriate response or appeal, and tracks the claim through resolution.

UHS can integrate lockbox activity with the Workers' Compensation service and convert paper remittance information into normalized ANSI X12 835 data for agreed posting workflows. Exclusive market claims should be used only after substantiation review.

No. UHS operates around the provider's existing systems and returns agreed claim, payment, remittance, and reporting information through defined interfaces and files.

Many implementations can reach go-live in approximately 30-60 days. Timing depends on scope, systems, data readiness, security and legal review, connectivity, testing, and client availability.

UHS describes its Workers' Compensation operating model as domestic and U.S.-based. Client-specific technology, security, and subcontractor requirements should be confirmed during diligence.

Reporting can include inventory, cash, aging, claim status, timeliness, first-pass performance, denials, expected allowed, underpayments, appeals, payments, and root causes. Measures are finalized for each engagement.

Results depend on baseline performance, claim mix, states, payers, data quality, retained responsibilities, and implementation. UHS should establish the baseline and measure changes in cash, denials, A/R, expected-allowed realization, write-offs, and workload.

UHS generally uses contingency pricing tied to recoveries. Rates depend on scope, account age, volume, provider type, jurisdiction mix, and operational complexity. Exact inclusions and fees are documented in the proposal and agreement.

A provider can request a focused Workers' Compensation claims assessment. UHS will review the current inventory, workflow, systems, performance, and objectives before recommending Day 1 services, legacy A/R recovery, or another defined scope.