Health

ODG Incorporates State Fee Schedules into Workers’ Compensation Solution

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ODG by MCG, an MCG Health company

“This ODG enhancement will help streamline negotiations, guide appropriate claim decisions, and support claim automation to flag bills that fall outside expectations.” – CJ Hallas, ODG Senior Product Owner


AUSTIN, Texas (PRWEB)

ODG by MCG, an MCG Health company and part of the Hearst Health network, announces that state-specific fee schedules are now available in its ODG for Workers’ Compensation solution. The new enhancements are expected to help insurance carriers that cover work injuries simplify the billing process and provide better support for claim decisions. ODG incorporated fee schedules into its ODG for Auto Injury solution earlier this year.

State fee schedules are widely known as lists of maximum rates a payer (or insurance carrier) will allow for services based on code sets such as CPT, HCPCS, and CDT codes. These schedules are considered important for organizations involved in adjudication or review of bills for workers’ compensation and/or auto injuries. ODG by MCG, an evidence-based web platform for workers’ compensation guidance adopted in many U.S. states, is now providing these state-specific fee schedules for insurance carriers to reference and use in cost comparison analyses.

The detailed schedules for 43 states where fee schedules are currently published are available within the ODG TAO Index solution. In addition, they can be integrated via API (application programming interface) into existing claims management systems. End users can filter the fee schedules by region, rate modifiers, types of service, and places of service. The ODG team designed the new feature to help adjusters and claim processors optimize workflow efficiency and to help accurately reference costs during the billing process.

ODG Senior Product Owner, CJ Hallas, said, “Having access to in-depth fee schedule information will bring value to insurers, clinicians, and claims management professionals set proper expectations.” He added, “This ODG enhancement will help streamline negotiations, guide appropriate claim decisions, and support claim automation to flag bills that fall outside expectations.”

For additional information or questions about this update, please contact an ODG representative at 1-800-488-5548 or odghelp@mcg.com.

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About ODG

ODG, an MCG Health company, (http://www.mcg.com/odg) provides unbiased, evidence-based guidelines that support workers’ comp, disability, and auto liability claims and medical management in their efforts to confidently and effectively return people to health. The clinical guidelines and analytical tools within ODG are designed to improve and benchmark return-to-work performance, facilitate quality care while limiting inappropriate utilization, assess claim risk for interventional triage, and set reserves based on industry data.

About MCG

MCG, part of the Hearst Health network, provides unbiased clinical guidance that gives healthcare organizations confidence in delivering patient-centered care. MCG’s artificial intelligence and technology, infused with clinical expertise, enable its clients to prioritize and simplify their work. MCG’s world-class customer service ensures that clients maximize the benefits of licensing MCG solutions – demonstrating improved clinical and financial outcomes. For more information visit http://www.mcg.com or follow our Twitter handle at @MCG_Health.

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