MTM specializes in California State Workers Compensation claim billing and recovery. Our average recovery rate is 90% of the amount that is recoverable within 60 days of the bills submission.
MTM is one of the industry's top performers, delivering you outstanding financial results, fully utilizing the knowledge, experience and success of our 25+ years of experience people on board!
We also specialize in personal injury/motor vehicle cases. MTM will communicate with the insurance adjustors and attorneys to track when the claim is settled and paid. We negotiate maximum settlements!
One advantage that we enjoy at MTM is that we have established longstanding relationships with insurance adjusters/supervisors, as well as defense attorneys, which enable us to shortcut many of the usual delays and stalling tactics that are often obstacles to timely and optimal reimbursements. Bills are also checked for acknowledgement prior to a denial being issued. MTM has the capability to initiate start the claims resolution process and finalize the claim resulting in a PAID IN FULL.
We specialize in QME and AME billing, and our QME/AME billing collection rate has been 100% within 30 days of claim submission.
Workers Compensation Process at MTM
- Workers Compensation Liability Verification: We call the employer/insurance carrier to verify the patient's benefits and the assigned Claims Adjustors. All attempts will be made to obtain the proper claim number for billing purposes, if the claim number is not on file.
- Authorization: MTM can assist you by obtaining authorization for treatment or testing. We can complete the request for authorization (RFA) on behalf of our medical providers and submit it to insurance/employers, and we will make every effort to obtain authorization from/for the physician and follow up until it is obtained. MTM will obtain authorization for additional tests or treatments requested.
- Electronic Claims Processing: We process all workers’ compensation claims electronically and if required, through paper, we have established relationships with multiple clearing houses to properly submit claims electronically.
- Payment Posting/Payment Reconciling: We match all the EOBs/EORS received from insurance company and reconcile the payment as per the OMFS, as well our software has the capability to store and automate the payment posting.
- Second Bill Review / Independent Bill Review: As per current Labor Code rules, we follow strict Second Bill Review guidelines and appeal each and all the EOB for underpaid cases within 48 hours of receipt from insurance.
- Litigation: We Litigate cases based on the merit and aggressively work with the defense/Insurance adjuster to collect the outstanding balances. We are an EDEX/EAMS E-filer and electronically do Lien Filing, DOR Filing, Petitions for Benefits.
- Hearing Representation: We serve entire Southern California region and have hearing reps available for representation at any Workers’ Compensation Appeals Board (WCAB) in the area.