Workers' comp transportation software: rides to therapy, exams, and depositions on the right claim

What does workers’ comp transportation software have to do?

It has to keep the authorization beside the trip, record the trip as it was driven, and produce the invoice each payer wants. A workers’ comp ride is paid against someone else’s approval, so the paperwork decides whether it gets paid. How these rides are booked and who pays for them is covered in workers’ comp transportation. This page covers the software side.

• Keep the authorization with the ride. The adjuster or network approves a specific ride, with its mileage, any wait time, and any extras. ProCare, for one, guarantees payment only for extras it approved before the ride.
• Record the ride as it was driven. Times, loaded miles, wait, and a signature give the office something to send when a ride ran differently from the plan.
• Invoice each payer its own way. Networks, insurers, and state funds ask for different items and run different clocks.

Why can the authorized trip and the driven trip differ?

Some payers fix the mileage and the extras before the ride and pay against that figure. In ProCare’s packet, loaded mileage is worked out with an online map and printed on the referral authorization, and the provider is paid on that number. A provider who disagrees has to tell ProCare before the assignment is completed. The rate sheet in the same packet adds conditions: extra stops, passengers, and alternate routes must be pre-approved, unloaded miles are not paid unless authorized before the service, and tolls and parking need pre-authorization and receipts. For each trip it pays the minimum trip amount or the per-mile rate times loaded miles, whichever is greater, and not both.

So GPS-recorded miles are evidence, not the basis for payment. They matter on the day a route runs differently from the authorized one, such as a closed road, and the office tells the payer before the trip ends. The trip log then shows the scheduled and actual times beside the GPS-verified miles for that trip, which is what the call to the network needs.

Which clocks in a network packet are easy to miss?

The wait-time report, the invoice correction window, and the appeal window. ProCare’s 45-day invoice limit, its 30-day payment term, and its no-show approval rule are in the workers’ comp transportation guide. The packet also holds these:

• Wait time. It is paid only when pre-authorized. The agreement says to report the total within 48 hours of the assignment, and the rate sheet in the same packet says 24 hours. Wait time reported after 48 hours is adjusted to a minimum of 1 hour on the invoice.
• Corrections. Revisions to a submitted invoice have to arrive within 24 hours of the original submission.
• Appeals. A payment decision can be appealed within 30 days of the explanation of payment date, by email with the referral numbers, the dates of service, and the reason.
• Payment inquiries. When a payment is past due and no explanation of payment arrived, the provider has 120 days from the date of service to send an inquiry.
• The authorization number. The sample authorization form in the packet says the number must be submitted on the invoice.
• Billing anyone else. Under the agreement, trying to collect from the injured worker, the employer, or any party other than ProCare cuts the amounts due by 30 percent, except where the law requires it.

Each item is a date or an approval that a dispatcher has to catch while the day is still moving. Software helps by putting the wait time and the approval on the trip itself instead of in a text thread.

Which rides are not treatment visits?

Depositions and required medical examinations are expenses of the claim, and they follow their own rules. In California, when the employer or insurer asks to depose an injured employee, Labor Code section 5710(b)(1) entitles the employee to all reasonable expenses of transportation, meals, and lodging incident to the deposition. That makes the ride an expense the worker is owed, though it is not a treatment trip. Ask the adjuster who authorizes it and where the invoice goes.

Some states pay the worker rather than the transport company. Texas rule 134.110 reimburses the injured employee, who sends the carrier a request with documentation such as itemized receipts, so a clear itemized trip record is the paper a worker needs there. The mileage thresholds and the form are in the workers’ comp transportation guide.

How should a recurring therapy ride follow its authorization?

It should stop on the last authorized visit. ProCare pays only for services it authorized, and its agreement says it accepts no advance billing. A physical therapy series booked for the whole course of care can therefore run past what the adjuster approved. Set the series to end on the last authorized date, drop visits the worker cancels, and ask for a new authorization before more rides are generated.

Privacy belongs in the same setup. ProCare’s service terms require that everything about the claimant, including legal and financial matters, stay confidential. The claim number and the adjuster’s contact details belong in notes only the office sees, and the driver needs the pickup, the destination, and what the rider needs on the way.

Running workers’ comp rides in HealthRide

Each trip a driver runs in the driver app carries its arrival, pickup, and drop-off times and GPS-recorded miles, plus the rider’s on-screen signature and the recorded wait when a rider does not show, and the trip log exports to CSV or PDF for a network or carrier. Ending a recurring trip series when care changes removes the remaining future trips. Dispatcher notes on the rider’s profile stay internal and are never shown to drivers, which suits claim numbers and adjuster contacts. Checks and bank payments from networks and insurers are recorded in the same ledger as card payments, matched to trips and invoices.