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First Aid & Bill Review

Not Every Injury Should Be a Recordable Claim. Proper claim classification and medical bill accuracy directly impact your experience modification rate and your total cost of risk. We review every bill and every claim to make sure you are not paying more than you should.
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Review Scope

What Our Review Covers

Medical Bill Auditing

Every medical bill associated with a workers compensation claim is reviewed for accuracy, duplicate charges, and appropriateness. Overcharges are challenged and corrected.

First Aid Classification

Not every workplace injury needs to become a recordable claim. We review treatment records to identify incidents that qualify as first-aid-only under OSHA guidelines — keeping them off your loss experience.

Fee Schedule Compliance

Medical providers must bill within state fee schedule limits. We verify that charges comply with applicable fee schedules and flag overcharges for adjustment.

Unnecessary Treatment Identification

We review treatment plans for services that are not medically necessary or not related to the workplace injury. Inappropriate treatment inflates claim costs and delays recovery.

Impact

The Financial Impact of Accurate Classification

A single misclassified claim can impact your mod rate for up to three years. Accurate first aid classification and medical bill review protect your experience from unnecessary inflation.

First-aid-only claims removed from mod rate calculations
Overcharged medical bills corrected and adjusted
Lower reserves through accurate cost projections
Improved mod rate from cleaner claim experience
Reduced total incurred costs on your loss runs
Better positioning at renewal with accurate data

FAQ

Frequently Asked Questions

What is the difference between a first aid claim and a recordable claim?+
Under OSHA guidelines, first aid treatment includes one-time wound cleaning, bandaging, non-prescription medications, and similar minor care. If treatment goes beyond first aid — such as prescription medications, physical therapy, or restricted duty — the incident becomes recordable and impacts your experience modification rate.
How does proper claim classification affect my mod rate?+
Only recordable claims are included in your mod rate calculation. If a claim is improperly classified as recordable when the treatment was actually first-aid-only, it inflates your mod rate unnecessarily. Correcting this classification can remove the claim from your experience.
How much can medical bill review save?+
Savings vary based on claim volume and medical provider billing practices, but it is common to find 10-30% in overcharges across a book of open claims. The savings flow directly to lower reserves and a better mod rate.
Do you handle the billing disputes with providers?+
Yes. When we identify overcharges or billing errors, we work with the carrier and the medical provider to correct them. You do not need to manage these disputes yourself.

Make Sure You Are Not Overpaying

Let us review your current claims and medical bills to identify misclassifications and overcharges that may be inflating your costs.

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Or call us at (888) 524-0798