decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Workers' Compensation / Types of Workers' Comp Insurance
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Article Overview
This article explains the basic categories of workers’ compensation insurance and how they can differ by state. It is intended to help billing and claims staff understand the general structure of workers’ comp coverage, the entities that may handle claims, and why payment processes can vary across employers and jurisdictions.
Why This Topic Matters
Workers’ compensation billing often depends on knowing which organization is responsible for claim handling and payment. Understanding the general insurance structure can help practices route questions correctly and recognize why payment sources may differ for the same claim.
Article Sections
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Types of workers’ comp insurers
Introduces the main insurance arrangements used in workers’ compensation and notes that state rules can affect which type applies.
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Private insurance company
Describes the role of private carriers in workers’ compensation coverage and claim payment administration.
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State-controlled fund
Covers state-run workers’ compensation arrangements and the general role of state funds or bureaus in claim handling.
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Self-insured corporation
Explains the general structure of employer self-insurance and the different ways claims may be administered.
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Note
Summarizes additional payment situations, including high-deductible arrangements and guaranty coverage if a carrier fails.
What You Will Learn
- The basic types of workers’ compensation insurers
- How workers’ comp arrangements may vary by state
- General differences in claim administration across payer types
- Why payment sources for a claim may change over time
- What happens in broad terms when a carrier is no longer operating
Who Should Read This
- Medical billing staff
- Claims staff
- Practice managers
- Revenue cycle professionals
- Workers’ compensation billing specialists
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