PEO Workers’ Compensation Audit Program

Is your Professional Employer Organization (PEO) accurately pricing your benefits? CompWize will know. Our audits focus on errors or misstatements that lead to higher and erroneous billing. Our trained specialists find and correct these mistakes to reduce costs and expenses. These lower costs extend to ongoing savings in the future.

Another common practice relates to claim reserves. The carrier must set aside a reserve if your employee has an injury. They often over-reserve or leave reserves open after settling the claim. This everyday carrier practice inflates your EMOD, potentially impacting it for years. This is why CompWize analyzes and reviews every claim reserve for accuracy. Additional items we review include errors in classification and errors in payroll audits.

Subrogation Audit Program

Medical expenses are paid regardless of how an accident or injury occurs. Subrogation recovery focuses on health care payments reimbursements when a third party is at fault, or a workers’ compensation carrier should be paying the bills. For example, suppose you have paid medical benefits resulting from an injury caused by a third party. In that case, you may have the right to recover those expenses from the third party, their insurance company, or any other responsible party. CompWize provides highly-trained recovery consultants to evaluate each claim and file for reimbursement.

Hidden overcharges in workers’ compensation insurance are far more common than the insurance industry likes to admit and often get repeated year after year after year, in spite of competitive bidding by different insurers or agents.

EMODs are often overlooked because underwriters, auditors, and agents lack training in the rules governing EMOD calculation. And the rating bureaus that calculate EMODs tend to accept data at face value, reported by member insurance companies, without checking it for accuracy.