Workers’ Comp Bill Review & Fee-Schedule Audit
Cross Matter™ checks each bill against your state’s workers’ comp fee schedule, line by line, and auto-drafts an overpayment objection letter with the cited statute § for every variance. The math is exact and traceable to the schedule, every time.
- CMS-1500 / UB-04 fields auto-extracted from the bill
- GAF, facility, modifiers, and unlisted-code rules applied
- Every variance cites the rule basis and source schedule row
Stop the overpayments that hide in the line items
Most of a workers’ comp bill is priced correctly. The leakage is in the handful of lines billed above the allowed amount — the ones a manual review misses when a file runs hundreds of pages. Cross Matter reprices every line against the fee schedule that governs the claim and shows you exactly where the bill exceeds it.
A cited objection letter, drafted for you
For every variance, Cross Matter drafts the overpayment objection with the governing rule cited to the section, so what leaves your office is defensible on its face. You review and send — the arithmetic is already traceable to the schedule row it came from.
Frequently asked questions
- What is a workers’ comp fee schedule?
- A state-published table that caps what a provider may be reimbursed for a given procedure code on a workers’ comp claim. Anything billed above the allowed amount is subject to objection. Cross Matter reprices each line against the schedule that governs the claim.
- How does Cross Matter find overcharges on a medical bill?
- It extracts the coded line items from the bill, applies the schedule’s conversion factors and the applicable GAF, facility, modifier, and unlisted-code rules, and compares the result to the billed amount. Each flagged line cites the rule basis and the source schedule row.
- Does it draft the objection letter?
- Yes. For every variance it auto-drafts an overpayment objection with the governing statute section cited. You review and send.
- Which bill formats does it read?
- CMS-1500 and UB-04, with the fields extracted automatically — including scanned and faxed bills.