Medical Claims Processing, Apex EDI Billing Clearinghouse, medical claims processing.#Medical #claims #processing


Medical Claims Processing

Stop sending claims the old-fashioned way. We ll save you time and money!

Process your electronic claims with Apex EDI and get paid faster, 5-12 days.

OneTouch ® electronic claims delivery is fast, convenient, and affordable!

Our Clients are Big Fans

We deliver Wow! through caring.

This has been one of the best decisions I ever made. Our payments are arriving much faster than ever before and we are not having to do any duplicate filing.

John A. McCall Jr., OD

We have been very pleased with the service Apex has provided to our office. It has saved much time and hassle getting claims paid in a shorter time period.

Dr. M Kelly Soutas

I strongly recommend that all medical and dental providers and billing services consider using Apex EDI as an effective tool to reduce administration costs

I would like to take a moment and express my gratitude. Our transition to Apex has been the smoothest transition I have ever been involved with. From the moment

I couldn t be happier with the level of service that I have received; from the first day I felt I was in very capable hands. I look forward to the day I can pass on

By taking advantage of Apex we have cut our billing time down significantly, and payments from insurance companies are coming in a quick, concise, and

I just wanted to let you know we are seeing payments and the turnaround time is AMAZING! Apex is allowing us to collect so much faster than before, and

News Events

Medical billing is a complex task where many things can go wrong. It takes

Telemedicine is not a passing trend. It’s the future of healthcare, with

The U.S. recently faced back-to- back major hurricanes. Texas and Florida h

Thousands of practices use our products and services to increase productivity and improve patient care.

Apex EDI takes the headache out of processing medical claims, dental claims, optometry claims, and chiropractic claims. Our solutions simplify the claims delivery process. We offer OneTouch ® electronic claims processing, real-time eligibility verification, patient statements delivery, and electronic remittance advice (ERA) and tools that accelerate the patient payment collection process.

Medical claims processing

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Apex EDI has created the OneTouch ® solution to offer you an easier and less expensive way to process your insurance claims electronically and receive faster reimbursement.


The medical billing insurance claims process, medical claims processing.#Medical #claims #processing


Medical Billing and Coding Online

The medical billing insurance claims process starts when a healthcare provider treats a patient and sends a bill of services provided to a designated payer, which is usually a health insurance company. The payer then evaluates the claim based on a number of factors, determining which, if any, services it will reimburse.

Let’s briefly review the steps of the medical billing procedure leading up to the transmission of an insurance claim. When a patient receives services from a licensed provider, these services are recorded and assigned appropriate codes by the medical coder. ICD codes are used for diagnoses, while CPT codes are used for various treatments. The summary of services, communicated through these code sets, make up the bill. Patient demographic data and insurance information are added to the bill, and the claim is ready to be processed.

Processing Claims

A number of technical protocols and industry standards must be met for insurance claims to be delivered expediently and accurately between medical practice and payer.

Medical billing specialists typically use software to record patient data, prepare claims, and submit them to the appropriate party, but there isn’t a universal software application that all healthcare providers and insurance companies use. Even so, insurance claims software use a set of standards, mandated as by the HIPAA Transactions and Code Set Rule (TCS). Adopted in 2003, the TCS is defined by the Accredited Standards Committee (ACS X12), which is a body tasked with standardizing electronic information exchanges in the healthcare industry.

There are two different methods used to deliver insurance claims to the payer: manually (on paper) and electronically. The majority of healthcare providers and insurance companies prefer electronic claim systems. They are faster, more accurate, and are cheaper to process (electronic systems save around $3 per claim). But because paper claims have not yet been completely removed from the insurance claims process, it is important for the medical biller and coder to be well versed with both electronic and hardcopy claims.

Filing Electronic Claims

Certain technologies have been introduced into the system in order to expedite claim processing and increase accuracy.

Some healthcare providers use software to electronically enter information into CMS-1500 and UB-04 documents. Using “fill and print” software eliminates the possibility for unreadable information. This software may also include certain types of “scrubbing,” or tools that check for errors in the documents. While these tools do decrease the amount of errors made in filling out claim forms, they are not always 100 percent accurate, so medical billers should remain diligent when filling out forms using software.

Optical Character Recognition (OCR)

OCR equipment scans official documents, electronically isolating and recording information provided in the different fields, and transferring (or auto-filling) that information into other documents when necessary. While OCR technology helps make hardcopy claim processing much more efficient, human oversight is still needed to ensure accuracy. For instance, if the OCR miscalculates a simple digit in a medical code, that error must be flagged and manually corrected by a medical billing specialist.

Note that when OCR equipment is not available, it is possible for a medical billing specialist to manually convert CMS-1500 and UB-04 documents into digital form using conversion tools called “crosswalks” (note that the same term applies for tools used to convert ICD-9-CM codes to ICD-10-CM). You can find crosswalk references from a number of different sources.

Filing Manual Claims

Paper claims must be printed out, completed by hand, and physically mailed to payers. The healthcare industry uses two forms to submit claims manually. Since processing paper claims requires more manual interaction with forms and data, the opportunity for human error increases compared to electronic claims. Documents can be printed improperly, and handwritten codes can be incorrect or illegible. The forms can also be mailed to the wrong address, with insufficient postage, or disrupted by logistical complications with the delivery services. These errors are costly for the healthcare provider, often resulting in form resubmission (a time-consuming process) and payment delays.

Generally, healthcare professionals like family physicians use form CMS-1500, while hospitals and other “facility” providers use the UB-04 form.

The CMS-1500 is the universal claim form used by non-institutional healthcare providers (private practices, etc.) to bill Medicare for Part B covered services and some Medicaid-covered services, and is accepted by most health insurance providers. The CMS-1500 is maintained by the National Uniform Claim Committee (NUCC), and was previously updated to include National Provider Identifiers (NPIs), or unique numbers required by the Health Insurance Portability and Accountability Act (HIPAA).

Form CMS-1500 contains all the basic information needed to submit an accurate claim. This includes fields for the patient’s demographic information, insurance information, and boxes in which to provide medical codes and corresponding dates of service. Certain boxes are used exclusively for Medicare and/or Medicaid. It is important to note that different payers may provide different instructions on how to complete certain item numbers. The medical biller and coder should be familiar with specific payer requirements before filling out the form.

Form UB-04, also maintained by the NUCC, is very similar to the CMS-1500, but it is used by institutional healthcare providers, such as hospitals. Like the CMS-1500, the UB-04 is used in lieu of electronic claims when the facility meets any number of exceptions granted by the ASCA. It is the responsibility of the facility to self-assess whether these designated exceptions apply to their operation, granting usage of manual claims. Also similar to the CMS-1500, certain payers may not require all fields, or data elements, to be completed.

The role of clearinghouses

Once a file is created using these standards, it is usually sent off to a clearinghouse. The clearinghouse is a third-party operation that primarily acts as a middleman between healthcare providers and insurance carriers.

Think of the clearinghouse as a central hub, or a single location where all claims are sent to be sorted and directed onward to all the various insurance carriers. Typically, clearinghouses use internal software to receive claims from healthcare providers, scrub them for errors, format them correctly in accordance with HIPAA and insurance standards, and send them to the appropriate parties. Clearinghouses generally keep medical practices in the loop during this process by providing reports on the status of claims.

This third party is necessary because healthcare providers typically have to send high quantities of insurance claims each day to a variety of different insurance providers. Each of these insurance providers may have their own submission standards. If a medical practice’s billing staff was solely responsible for transmitting insurance claims under both insurance and HIPAA requirements, the potential for error would increase dramatically, not to mention the time required for formatting each claim to specific insurance carrier.

When choosing a clearinghouse, a healthcare provider should consider two main factors:

  • Does the clearinghouse have the capability to work with the insurance providers the practice works with most often?
  • Can the clearinghouse accommodate claims transmissions from the insurance provider’s practice management software?

Confirming these questions ensures that all transmissions run smoothly.

Wrapping Up Course 5

Healthcare providers prepare insurance claims using information provided in the patient’s bill. Occasionally, the claim is prepared manually and sent by mail. In most cases, the claim is sent electronically (having either been prepared using claim software or scanned from a hard copy) to a clearinghouse. The clearinghouse checks the claim for errors, formats it according to HIPAA and insurance guidelines, then transmits it to the appropriate payer, while also sending a report back to the healthcare provider.

After the claim has been evaluated, the insurer must provide both the patient and healthcare provider with an Explanation of Benefits (EOB). The EOB breaks down the adjudication process, showing the dates of service, procedures and charges, patient financial responsibility, and the amount paid to the healthcare provider. At this point, the health insurer sends payment to the healthcare provider, usually in the form of an electronic fund transfer.

The insurance claims process can be complex. Fortunately, there are tools to help complete insurance claims on a day-to-day basis. Medical billing professionals who are familiar with these tools and all documents (both paper and electronic), industry standards, individual insurance company regulations, clearinghouse procedures, and the adjudication process will be prepared to succeed.


IHCFA Claims Processing, Home, medical claims processing.#Medical #claims #processing


medical claims processing

iHCFA Well Positioned to Support New Jersey s EDI Law for Electronic Filing of Medical Bills for Worker s Compensation Claims

Morristown, NJ. (November 14, 2016) – iHCFA, LLC an industry leading clearinghouse, specializing in the electronic processing of Workers Compensation and Automobile bills, announced today that it is poised to support healthcare Providers and insurance payors in implementing the new S-2136 Electronic Data Interface (EDI) bill signed into law today by New Jersey Governor Chris Christie.

The new law requires all Workers Compensation, Third Party Administrators and Employers who receive medical bills to accept the bills and their medical reports electronically. All healthcare Providers and Hospitals that submit over twenty-five (25) bills per month are also required to submit their bills and medical reports electronically. The Department of Banking and Insurance will utilize the national standard ASC X-12 electronic data exchange protocols found in all modern billing systems.

Company President, Dr. William J. DeGasperis, stated, this law moves New Jersey into the 21 st century and will result in lower costs, greater accountability, productivity and a better working relationship between the Provider and insurance payor. iHCFA is uniquely positioned to help clients comply with this new law because of our ability to connect to any medical billing system and link to more than 1,000 insurance payors and third-party administrators, said DeGasperis.

The benefit for healthcare providers managing their revenue cycles through e-billing, besides faster payment, is the increased efficiency of direct point to point communication between the insurance carrier and the Provider billing system. The elimination of lost bills and an overall reduction in administrative costs and burdens results in a more effective, efficient process. Providers currently submit over 95% of all Medicare, Medicaid and healthcare bills electronically yet submit only 10% of all Workers Compensation and Auto bills. Payors receive faster notification of claims through the e-billing process, more accurate and complete first-time bills and medical documents, better communication and a significant reduction in paper and mail room processing. These all lead to decreased costs and eliminate reliance on antiquated manual processing.

iHCFA, a New Jersey based clearinghouse, specializes in electronically processing Workers Compensation and Automobile bills with all supporting documents. iHCFA is an industry leader with the ability to connect to any medical billing system and link to more than 1,000 insurance payors and third-party administrators in all 50 states. iHCFA users can access a web based system to perform bill validation, review processing status including acceptance or rejection and payment notifications.


What is a Medical Claims Specialist? (with pictures) – mobile wiseGEEK, medical claims processing.#Medical #claims


wiseGEEK: What is a Medical Claims Specialist?

A medical claims specialist is also known as a health claims specialist or medical billing specialist, and is an employee who works for a hospital, doctor’s office, or insurance company. The medical claims specialist is responsible for assigning the correct insurance and procedural codes to bills, processing insurance forms, and performing patient billing services. Education requirements vary depending on the physician’s office or type of billing to be processed.

A medical claims specialist may only be required to have a high school diploma, and often some experience working in a healthcare environment, usually as an administrative assistant. He or she may then receive on-the-job training to be a claims specialist. Some offices or healthcare businesses require their claims specialists to have an associate’s degree in health information technology, however, along with one of the following certifications: Certified Coding Specialist (CCS), Certified Coding Associate (CCA), or Certified Coding Specialist-Physician-based (CCS-P).

Many community and vocational colleges offer classes or certification programs in this type of work. Students learn medical terminology as well as the billing codes necessary for submitting claims to insurance companies. These are known as Current Procedural Technology (CPT) codes and International Classification of Diseases (ICD) codes. It is important for a medical claims specialist to know and understand insurance laws in order to process the claims correctly.

In addition to filling out forms for insurance companies, a medical billing specialist will also need to process payments received from patients and insurance companies, and apply them correctly to various accounts. Disputes often arise between patients and insurance providers, and a medical claims specialist will likely need to spend much of his or her day on the phone resolving these issues, so it is important for a claims specialist to have good customer service skills, and the ability to multi-task efficiently. Medical claims specialists frequently answer questions regarding billing or insurance when patients call the office or call center at a hospital.

Medical claims specialists will need to be neat and organized, as their job will frequently require maintaining a file system. They need to have excellent computer and data entry skills, and a high attention to detail. Some medical claims specialists are able to work from home, once they have established themselves as efficient and careful workers within an office. Typically, a medical claims specialist will work regular weekday hours, and receive a fairly good income with benefits; this makes this career a good choice for many people.

Article Discussion

5) I have worked for some of the biggest health insurance companies, as well as at facilities, with specialty doctors and even with a third party administrator.

I have worked as a claims specialist, a claims auditor, a trainer, insurance verification specialist, claims examiner and much more and I would have to say from a managerial point of view, 67 percent or more of business is handled by overseas reps due to cost.

On the claims specialist side, it’s frustrating to talk to someone in disputing claims when they do not understand health care in general because they either don’t have health insurance, or they have free health care and thus do not have to deal with these tedious disputes of resolving a claim.

However, all of you are correct: it is definitely a career that has longevity. It’s impossible to get rid of such a position as a whole. Claims specialists do not pay very well if you compare the numbers to other positions.

4) @allenJo – Outsourcing does not necessarily mean overseas. There are third party providers here in the United States who provide medical billing services.

On balance, I think that many doctors’ offices are finding that it’s better to outsource to these companies because they don’t have to pay salaries and benefits.

Of course, if you pursue this field, you could always see if you could work for the third party firm, since they hire experienced coders as well.

However, I still think there is plenty of demand for in house medical coding. If it’s something you really want to do I think you should do it.

3) @everetra – One concern that some people have is whether medical claims jobs as a whole are being outsourced overseas to places like India. I know some hospitals have already begun to do that, which I think is a shame.

You would think that a job which requires good customer service skills would remain in the states. I realize that there is a lot about medical coding that is routine and mostly data entry driven, but when you have to settle a billing dispute you want someone local and easily accessible.

2) @Charred – I believe that a medical insurance specialist is a valid career choice; however I don’t think that they would make the kind of money that your newspaper ad described. I think it’s closer to $15 an hour for starting pay, from what I understand.

I do know one person who does the work from home, but she started out working at the office. Because of her newborn child she persuaded the doctor to let her work from home, at least for awhile. It’s not expected, however, that specialists will work from home and the industry generally discourages this practice as it can put the doctors in a bind.

However, it is possible. Like so many things that turn out to be too good to be true, there is a kernel of truth in what the advertisement was promoting but it was a misrepresentation of how many people do their work.

1) While I am sure medical claims specialist jobs abound, you should always beware of scams masquerading as work from home opportunities.

Some years ago I answered an ad in a local newspaper that claimed to tell me all I needed to know about becoming a medical billing specialist. All I would have to do is take a course.

For that, they wanted $400 and claimed that I would be making $60,000 a year. Well, fortunately I didn’t even have $400 at the time. After doing some research later on I then discovered that many of these operations were scams; no one can tell you everything you need to know in a work from home course.

Further, as the article rightly points out, most of the legitimate jobs are not work from home – they work on site, in the doctor’s office. It’s a medical career like any other; there are no shortcuts.


Why Your Workers – Compensation Claim Could Be Denied, claim for compensation.#Claim #for #compensation


Why Your Workers Compensation Claim Could Be Denied

Workers’ compensation insurers deny many legitimate claims, forcing honest and innocent employees to hire a lawyer and go through the workers’ compensation system to enforce their rights. Why do they deny rightful claims? Some of the main reasons why workers’ compensation insurers deny claims are the following:

  • your injury was unwitnessed
  • you didn’t report your injury immediately
  • there is a discrepancy between your accident report and initial medical records
  • your initial medical records indicate the presence of illegal drugs in your system
  • you filed a workers’ compensation claim after you were fired or laid off
  • you refused to give the insurance company a recorded statement or refused to sign medical authorizations.

Your Injury Was Unwitnessed

Workers’ compensation insurers never like unwitnessed injuries. They question the vast majority of unwitnessed accidents. If you get hurt at work and no one saw your accident, there is nothing that you can do about that. But you should certainly make sure to report the injury to your co-workers and to your supervisor immediately, and you should make sure that you tell everyone the exact same thing about how your injury occurred.

You Didn’t Report Your Injury Immediately

Workers’ compensation insurers don’t like cases where the accident doesn’t get reported immediately either. They assume that, if you don’t report the accident immediately, you weren’t really hurt. Moreover, most states’ workers’ compensation laws require you to report work related injuries within a short time period, sometimes in as little as seven days. Don’t wait. If you get hurt at work, and you think that your injury has the slightest chance of causing you to miss any work, report it immediately to a supervisor and fill out an accident report. That will comply with the law and will help your chances of getting benefits as soon as you need them.

There is a Discrepancy Between Your Accident Report and Initial Medical Records

Insurers will often deny workers’ compensation claims if the employee’s statements about how the accident happened are inconsistent. If you tell your supervisor that the accident happened one way, but tell your doctor that the accident happened in a different way, that will hurt your case. Make sure that, when you tell co-workers, supervisors, people in the personnel office, and health care providers about the accident happened, you are consistent.

Your Initial Medical Records Indicate the Presence of Illegal Drugs in Your System

If an employee goes to the emergency room after a work-related accident, and the emergency room records show illegal drugs in the employee’s system, the insurer is almost definitely not going to voluntarily pay workers’ compensation benefits to that employee.

You Filed a Claim After You Were Fired or Laid Off

Sometimes, employees who were legitimately injured at work delay filing a workers’ compensation claim and by the time they get around to filing the claim, they get fired or laid off. Insurers never like workers’ compensation claims that are filed after the employee gets fired or laid off. They almost always assume that the claim is nothing more than a revenge claim. This is another reason not to wait to file a claim if you have a legitimate work related injury. If you get laid off before you file your claim, you are going to have a difficult time convincing the insurer and the workers’ compensation judge that you really did have a work related injury.

You Refused to Give the Insurance Company a Recorded Statement or Refused to Sign Medical Authorizations

Workers’ compensation insurers will often ask injured employees to give a recorded statement describing the accident and the injuries. Unfortunately, that puts the employee in a difficult position. As a general rule, giving a statement will not help an injured employee who does not have a lawyer. Nor is the employee legally required to give the insurer a recorded statement. If the insurer asks for a statement, that is usually a sign that the insurer has a problem with the case. If the employee gives the statement, the insurer is still probably not going to put that employee on workers’ compensation benefits. But if the employee refuses to give the statement, then the adjuster can tell the employee that his/her failure to give the statement prevented the insurer from starting compensation benefits.

Insurers will also generally ask the employee to sign medical authorizations that will allow the insurer to write directly to the employee’s health care providers to get the employee’s medical records and bills. Again, the employee generally has no legal obligation to sign medical authorizations. An injured employee who is filing a workers’ compensation claim does have the obligation to give his/her medical records and bills relating to the work accident to the insurer, but he/she can meet that obligation by simply getting the records on his/her own and sending them to the insurer.

However, insurers don’t like when employees do that. They don’t trust injured employees. Insurers like to get the medical records on their own. That way they can be sure that they get a complete file, not one that has been cherry-picked. The problem with medical authorizations is that sometimes the insurer will invade your privacy and get medical records that do not relate to the work accident.

If the insurer pushes you to sign a medical authorization and you would prefer not to sign one, then you should contact a workers’ compensation attorney immediately, and let him/her deal with the insurer.


Understanding Your Auto Insurance Policy, bodily injury liability.#Bodily #injury #liability


What is auto insurance?

All insurance provides protection to consumers by covering certain risks and promising to pay for financial losses caused by these risks.

Auto insurance is one of the most used types of personal insurance. Most states require that you purchase some kind of insurance coverage to drive legally in the state. Auto insurance can be divided into two basic coverage areas: liability and property damage.

Liability

Most auto insurance policies contain three major parts: liability insurance for bodily injury, liability insurance for property damage and uninsured/under-insured motorists coverage.

Bodily injury liability insurance protects you against the claims of other people who are injured in an accident for which you were at fault. Their claims for bodily injury may include medical expenses, lost wages, and pain and suffering.

Property damage liability insurance pays for any damage you cause to the property of others. This includes not only damages to other vehicles, but also other property such as walls, fences and equipment. Uninsured motorists coverage protects the policy holder directly. This coverage pays if you are injured by a hit-and-run driver or a driver who does not have auto insurance.

Property Damage

Property damage coverage may include both collision coverage and comprehensive coverage.

Collision coverage pays for physical damage to your car as the result of your auto colliding with an object, such as a tree or another car. This coverage is optional and not required by law. However, collision insurance may be required by your lending institution or lessor. In the case of an accident involving an older car, the cost of repairing the car can quickly exceed the worth of the car. In this case, insurers will total the car and pay you what the car was worth rather than fixing it.

Comprehensive coverage pays for damage to your auto from almost all other causes, including fire, severe weather, vandalism, floods and theft. Comprehensive coverage also will cover broken glass, such as windshield damage. You are not required by law to carry comprehensive coverage.

Understanding Your Auto Insurance Policy

Your policy is divided into sections. It details types of coverage, rights and obligations under the policy and exclusions or limitations. Types of coverage may include liability, medical payments, uninsured/underinsured motorist, and coverage for damage to your auto.

Declarations Page

An insurance policy is a legal contract. Your policy begins with a declarations page. This identifies the policy number and provides important information including the policy term, coverage limits, and information about the insured. It also contains a description of the vehicles covered under the policy.

If you received a loan to purchase your car and there is still an outstanding balance, the lender will be listed as “loss payee” on the declarations page.

Insuring Agreement

Your policy contains a general insuring agreement consisting of a broad statement listing the perils and risks covered under the contract. The insuring agreement also identifies exclusions, which are specific events and circumstances the policy will not cover. It will contain definitions to help make the coverage clear and prevent any misunderstandings.

© 1991 – 2017 National Association of Insurance Commissioners. All rights reserved.


Adds disability compensation claim status feature – VAntage Point, claim for compensation.#Claim #for #compensation


VAntage Point

Claim for compensation

VAntage Point

Official Blog of the U.S. Department of Veterans Affairs

Vets.gov adds disability compensation claim status feature

Simplified, mobile approach allows Vets to more easily check claim status

Claim for compensation

Claim for compensation

There’s a common misperception that VA-and-DoD’s eBenefits web portal is singularly synonymous with “checking your claim.” Although claim status is one of several dozen features on eBenefits, it’s also one whose implementation many Vets felt could be improved.

Enter vets.gov, the VA transaction-based website. Yes, you will now be able to track the progress of your disability compensation claim online at Vets.gov.

Let’s back up, though, to address on question: Why?

What I mean to say is that we’ve heard you. That we’ve taken your suggestions to improve the claim status tracker. And since it’s one of our most-popular features, we’ve brought it—new and improved!—to the Vets.gov experience.

The claim status tracker is now simpler to use, easier to read, more responsive, 508 compliant, and best of all—it’s designed for mobile. These are the suggestions you—and other Veterans just like you—have told us in interviews, focus groups, surveys, testing and other feedback that we’ve received.

After you create a Vets.gov account, give it a whirl. We believe you’ll find it easier to understand. Look for clearer language, a cleaner and less-distracting design, an easy-to-navigate interface, and less-confusing steps in the timeline. Where there used to be eight steps in the claim process, there are now only five:

  1. Claim received
  2. Initial review
  3. Evidence gathering, review and decision
  4. Preparation for decision notification
  5. Complete

At the moment, disability compensation is the only claim status currently available on Vets.gov. Other claim types will be added in early 2017. This is also true for VA benefits in general: soon, you’ll be able to discover, apply for, track and manage all your VA benefits at vets.gov.

The eBenefits Portal is an online resource for tools and benefits-related information for wounded warriors, Veterans, Active Duty Servicemembers, their families, and those who care for them. The portal will remain active until Vets.gov is fully built.

Author

Jason Davis served five years in the 101st ABN, including two combat tours to Iraq. He’s currently an M.A. candidate in Writing at Johns Hopkins University and serves as social media administrator for the Veterans Benefits Administration.

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Victims Information Service: Getting compensation, claim for compensation.#Claim #for #compensation


Victims’ Information Service

Getting compensation

You may be eligible for compensation if you:

  • are a victim of a crime
  • are a close relative of someone who has died because of a crime
  • witnessed a serious crime, intervened and were seriously injured

There are many ways to get compensation. The most common are listed below in order of priority.

1: Insurance

You may be able to make a claim through different policies:

  • your insurance may cover a property crime like theft or vandalism. You’ll probably be asked for a crime reference number

If you disagree with an insurer’s decision you can apply to the Financial Ombudsman.

If you disagree with an employer’s decision, you can speak to ACAS.

2: Benefits

There may be benefits you can claim if you’re recovering from serious injuries.

If a relative has died, you may be entitled to bereavement benefits.

If you disagree with a benefits decision, you can apply to the Social Security and Child Support Tribunal.

3: Court

If the court decides an offender is guilty, the judge may make them pay you a sum of money as part of their sentence. This is called a Compensation Order.

4: Compensation from Government

  • This government fund is available to blameless victims of violent crime who can’t get compensation elsewhere
  • It can take a long time for a claim to be investigated and compensation paid

You’ll need to apply within 2 years of reporting the incident and have cooperated with any investigations. CICA will let you know if any other conditions might be relevant.

There are a lot of organisations that offer free advice and can help you apply. You won’t need to use a solicitor or claims management company. Enter your postcode in the box at the bottom of this page to find help where you live.

CICA can also provide compensation for those affected by recent terrorist attacks.

Glossary

A government document which sets out how you can expect to be treated by the police if you witnessed a crime, and if you have to give evidence in court. Different versions are available, including an easy-to-read brochure as well as the full charter in English and Welsh.

If you’re worried about your safety online

For information or for help with this site call 0808 168 9293

It’s free from a landline, but you may be charged if you call from a mobile

About Victims’ Information Service

This nationwide service helps you find local support after a crime takes place. It brings together information on what will happen after reporting a crime, the people you might meet, the help you should get and how to complain if something goes wrong.

All content is available under the Open Government Licence v3.0, except where otherwise stated


Sport Injury Solicitors, Compensation Claim, Australia, claim for compensation.#Claim #for #compensation


Sport Injury Solicitor – Compensation Claim Australia

Our Australian sport injury solicitors are experts in obtaining maximum compensation for personal injuries. If you have been injured whilst playing sport, you may be entitled to compensation for your injuries, disabilities, medical expenses and time off work. Call our solicitors advice line today to find out how our sports injury claim lawyers can help you obtain maximum compensation under the No Win No Fee scheme.

Obligation-free advice is available to all those injured as participants or spectators in sporting activities and events, including training in sports centres. Whether you are a professional athlete, amateur athlete, university, college or school student or an employee injured in a sporting event organised by work, you may be able to claim compensation for your sport injuries and disabilities.

Call our solicitors advice line, complete the contact form or send an email to find out how we can help you. Strict time limits apply in lodging claims for compensation, so you should not delay in seeking legal advice.

Who Can Claim?

If you play club sport, you may be able to claim compensation pursuant to an insurance policy or scheme (e.g. the NSW Sporting Injuries Insurance Scheme). Most sporting organisations have insurance cover for their members. So if a member is injured, compensation is payable regardless of fault.

If sport is your employment, and you are injured during training, playing sport or travelling to/from sporting events or training, you may be entitled to claim workers compensation.

If you have been injured as part of school or university sporting activities you may also be able to claim compensation pursuant to an insurance policy or under the common law.

If your injury is sustained as a result of carelessness or the intentional act of another player, you may be able to sue for common law damages.

If you have been injured as a result of unsafe premises, inadequate or unsafe sporting equipment or a dangerous sports ground, pitch or playing surface you may be able to take legal action against the organiser of the event.

If you have sustained injury at a sports centre as a result of premises being in a poor condition or machinery or equipment being defective or as a result of inadequate instruction we may be able to claim compensation for personal injury.

Compensation Awards

You may be able to claim the cost of medical expenses, rehabilitation expenses (physiotherapy, occupational therapy, chiropractic treatment, and remedial massage), dental expenses, loss of income, loss of earning capacity, attendant care, domestic assistance and legal costs.

Types of Injuries

Basketball

Basketball involves a considerable amount of running with explosive movements and rapid changes in direction and pace. Musculoskeletal injuries are the most common type of injury in basketball. These include back injuries, sprains, strains, contusions, dislocations and fractures. Wrist and hand injuries are common as are sprains and dislocations of PIP joints of the finger. Lower extremity injuries include: knee injuries, patellofemoral syndrome, anterior cruciate ligament injury, shin splints, stress fractures, patellar tendinitis (“jumpers knee”) and ankle injuries.

Brain injuries are less common in basketball. Concussion or mild traumatic brain injury (MTBI) can happen through player- to- player collisions or contact with the floor. Signs and symptoms of MBTI include transient loss of alertness, nausea, amnesia, confusion, headache, dizziness, visual disturbance, mood swings, changes in behaviour and cognitive decline.

Boxing

Brain injuries and concussion are the most common neurologic injuries in boxing. Nasal contusions, nose bleeds, facial lacerations, hand and wrist injuries are the leading non-neurologic injuries.

Bicycling

Bicycle crashes are the second leading cause of sports associated serious injury. Head injuries account for most bicycle related deaths. Falls on out-stretched hands can result in: scaphoid fracture, colles fracture, acromioclavicular (AC) joint separation—usually direct trauma to the involved shoulder, clavicular fracture. Crashes and falls from bikes can result in skin lacerations and abrasions, pelvic fractures, internal organ damage (liver, spleen, bowel, pancreas, abdominal wall). Knee pain, shoulder bursitis, rotator cuff tendinitis, neck pain, low back pain, ulnar neuropathy, carpal tunnel syndrome, tenosynovitis, achilles tendonitis, plantar fasciitis, hip bursitis and groin injuries are also common injuries found in bicycle riders.

Cricket

Fractures and bruising are the most common cricket injuries. Injuries to the face, teeth, jaw can occur when a ball hits the face. Bowlers may suffer from injuries to the shoulders, hands and the lower back. Fast bowlers tend to suffer from stress fractures, especially in the metatarsal bones, the fibula and the tibia.

Football / Rugby

The majority of injuries suffered by footballers involve the lower extremity with sprains, contusions, and strains being most common. Fractures account for 10% of injuries. Medial collateral ligament sprain is the most common knee injury. Anterior cruciate ligament is the most devastating knee injury commonly seen in footballers and generally requires surgical reconstruction. A thigh/quadriceps contusion is the most common soft tissue injury in football, resulting from blunt trauma. “Turf toe” is a sprain typically resulting from forced hyperextension of the planted toe on the turf. Shoulder instability and dislocations can result from tackling. “Jersey Finger” is another tackling injury- it is the forced extension of the actively flexed finger when trying to grasp an opponent; the athlete will feel a pop in the finger joint.

Head trauma is the greatest source of fatal injuries in football, generally from subdural hematomas. Mechanisms of injury include a direct blow to the head by an opponent or a blow to the head from hitting the ground. Brain shearing and acceleration/deceleration forces can also cause brain damage. Tackling, blocking and spearing can result in cervical spine injures (neck injuries) and brain injury. Damage to the spinal cord from trauma to the neck can result in quadriplegia. Lumbar spine injuries are another possibility.

Soccer

Soccer players are susceptible to high ankle injuries during collisions or contested balls. Ankle sprain can occur with pivoting, jumping, and hard turns with the ball. Soccer causes a high incidence of knee injuries, particularly meniscus injuries. Lower leg injuries (tibia and fibula fractures) can occur with aggressive slide tackles from behind. Successive head balls may result in brain injury analogous to the chronic progressive traumatic encephalopathy seen in career boxers.

Most injuries result from the golf swing, the equipment, or objects on the course. The lumbar spine can be injured as it rotates, side bends, compresses, flexes, and hyper extends during swinging of the golf club. Shoulder injuries and elbow injuries (medial and lateral epicondylitis) are also common. DeQuervain’s tenosynovitis is a common wrist problem seen in golfers. Wrist fractures can occur if the club head strikes a rock, stump or too much turf.

Tennis

Most injuries occur in the shoulder and elbow- rotator cuff tendinosis and tennis elbow. Lower extremity problems are typical as seen in other running sports, e.g. ankle sprains, knee injuries medial tibial stress syndrome, and achilles tendinosis.

Rowing

Back and knee injuries are by far the most common injuries to rowers. Back injury syndromes that can be seen include muscular and lumbar disk herniation. Patellofemoral pain (knee pain) is a common complaint among rowers. Tendinitis can occur in the patellar, quadriceps and forearm. Nerve entrapment syndromes such as digital nerve compression in the fingers, carpal tunnel syndrome, and sciatica are common complaints. Rib stress fractures can occur through muscle pulling during the row stroke.

SOLICITORS HELPLINE 1800 352 100

No Win No Fee Solicitors

Our Australian sports injury solicitors are able to act on a No Win No Fee basis. This generally means that there are no upfront costs, and the client does not have to pay their solicitor any legal fees if their claim is unsuccessful.

To find out how the No Win No Fee scheme operates and how we can help you obtain maximum compensation, call our free advice line today.


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Helping you find the right occupational health solutions

Helping you find the right occupational health solutions

At Occupational Medicals, we recognise that when it comes to occupational health for many employers, the two health matters which cause the most difficulties in occupational health and in the working environment are work absence and health issues caused by work.

Occupational Medicals provides a range of occupational health services to provide solutions to each aspect of these problems. These include:

  1. ABSENCE RECORD A web based system for employees to record absences and which provides automated triggers to the employer when set attendance targets are breached. The system can recognise frequent absence, abnormal trends and prolonged absence.
  2. ABSENCE TRACKER The system recognises atypical absences which are assessed by a health professional to determine if absence is appropriate and provides advice on access to health services and a return to work plan.
  3. SICKNESS ABSENCE ASSESSMENTS Provides expert assessment and a definitive report in more complex cases and those where the issues are considered to be caused by work.

Occupational Medicals not only provides occupational health expert assessment reports but will continue to work with employers until an occupational health issue is resolved. Our experts are available to provide ongoing occupational health advice to ensure employers achieve a viable solution.

The occupational health surveillance programmes benefit employers too by helping to prevent occupational health issues caused by work which lead to reduced employee productivity and potential liability claims against employers.

Work Stress Management

We have 30 years expertise in stress management and stress counselling and in instituting work stress policies and programmes to suit employers across a range of industry sectors. We will work with you to ensure that you have in place the relevant stress management policies, procedures and knowledge to manage this area to a high standard. The programmes include a range of services, policies and tools to help you institute effective stress management procedures for managers and employees. These include stress audit, stress workshops and e-tools to help monitor work stress.

Providing you with IT / E-Tools

We provide a range of IT capabilities which help you manage OH issues more efficiently and cost effectively.

The Portal provides you with capability to track employee occupational health issues from referral to provision of report. You will be automatically informed of appointments and when report is available to be viewed.

All occupational health surveillance results are available online and a reminder will be sent automatically when they are next due so giving you peace of mind that you have a complete solution for recording your obligations under the health and safety at work act.

A range of e-tools ,information and policies are available to download to help you manage occupational health issues in a cost effective manner. There are useful tips on establishing an effective work absence process. There are free workshop presentations to help managers in how to recognise work stress and tools to help monitor stress in the workplace. The occupational health surveillance tools help you determine which specific tests are relevant for your workforce and describe in detail the regulations regarding each test and how frequent they should be performed. (You will need your portal username and password to access this area)

With 30 years of occupational health experience we can provide you with information, e-tools, policies and bespoke solutions specific to your industry sector.

11/02/13 – News Update

Occupational Medicals is pleased to announce the launch of Online New Starter Medical Screening. Is your new employee fit to do the job you want them to do? Read more.

27/12/12 – News Update

Occupational Medicals relocates into new offices Read more.

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Sickness Absence Assessment

We assess employees to see if they are fit for work.

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Health Surveillance

We carry out targeted surveillance according to the.

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Employment Screen

We conduct employment screening, the majority.

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Stress Management

We help employers manage stress in their workforce.

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Key services

Client testimonials

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The occupational health service provision has been extremely helpful, and resulted in our sickness absence rates decreasing by 50 per cent. I feel that both the organisation and our employees benefit from their proactive service provision.

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– Marie Kelly, HR officer, Cheshire Peaks and Plains Housing Trust

Registered in England and Wales. Company Registration No. 06221455 VAT Registration No. 259184474

Registered address: Charles House, Albert St, Eccles, Manchester M30 0PW