Workers’ Compensation Recovery Solution
Navigate complex state-specific requirements and improve recovery outcomes with specialized expertise and technology-enabled operations.
Improve your workers’ compensation subrogation performance
Workers’ compensation recovery can be complex, especially when state-specific rules and procedures affect the path to recovery. Carelon helps health plans navigate that complexity with specialized expertise, automated workflows, and ongoing case management to strengthen recovery performance.
We designed our services supporting subrogation of workers’ compensation claims for health plans seeking scalable recovery operations, payment integrity improvements, and more efficient claims management processes.
Lines of business:
- Commercial
- Medicare Advantage
- Medicaid
- Federal employee
Audience:
- Payers
Bring more recovery opportunities within reach
Our workers’ comp revenue recovery specialists combine predictive analytics, automated identification tools, and case management expertise to help uncover opportunities, streamline workflows, and improve recovery performance.
Accelerate claims review
Using predictive analytics and automated workflows, we help identify and validate eligible workers’ compensation claims quickly and accurately to support faster recovery cycles.
Reduce administrative effort
Our technology-enabled approach reduces reliance on questionnaires and manual processes, simplifying recovery activities for health plans, providers, and members.
Streamline dispute resolution
Automated workflows and experienced recovery specialists help reduce delays, simplify dispute resolution processes, and minimize complexity and paperwork.
Technology built for state-specific workers’ compensation recovery
Our technology combines automation, analytics, and configurable workflows to support state-specific recovery requirements and improve reimbursement performance.
State-specific recovery configurations
Adapt recovery workflows to state-specific workers’ compensation requirements with configurable technology and processes.
Continuous claims monitoring
Continuously monitor claims for new recovery opportunities such as case details, eligibility, and other information change.
Automated outreach
Use automated outreach to follow up when there is no response, gather information needed for recovery, and reduce reliance on questionnaires and manual processes.
Technology-enabled case management
Support recovery teams with centralized case information, streamlined workflows, and greater visibility throughout the recovery process.
Real-time reporting and visibility
Track recovery activity and performance with reporting that gives you greater visibility into opportunities and outcomes.
How our subrogation process works
Review data integrity
We review data to identify inconsistencies that could affect recovery opportunities or reimbursement accuracy.
Identify recovery opportunities
We use predictive analytics and public and proprietary databases to identify potential recovery opportunities while reducing reliance on member questionnaires.
Manage subrogation cases
Our workers’ comp revenue recovery specialists manage ongoing cases, monitor claim developments, and help protect reimbursement rights throughout the recovery process.
Recover reimbursement
We negotiate settlements, obtain reimbursement, and monitor cases for additional recovery opportunities.
Connect with our workers’ compensation recovery experts
Contact Carelon to learn how our workers’ compensation recovery solution helps health plans improve reimbursement outcomes, streamline subrogation workflows, and strengthen payment integrity performance.
Explore related subrogation solutions
Complete a questionnaire or refer a case
Use the tools below to complete a subrogation questionnaire, refer a new case, or access information about our healthcare subrogation process.
Questionnaire
Received a questionnaire in the mail?
Submit your information securely online or review other response options.
Case referral
Want to refer a new case to us?
Submit your information online and find additional options here.
Frequently asked questions about workers’ compensation subrogation
Are you a health plan member seeking subrogation support?
Why did I receive a letter from Carelon about a subrogation questionnaire?
If you received a call, letter, email, or text from Carelon related to a subrogation questionnaire, we need additional information to determine if someone else should be financially responsible for your treatment.
For more information about a subrogation request, call the number listed on the subrogation letter you received.
You can also contact the Member Services number on your member ID card or use the member support contact information provided by your health plan.