Carisk Partners (fka iHCFA) is a clearinghouse specifically used for billing out claims only to Worker's Compensation and Auto Accident payers.
One difference with Carisk (fka iHCFA) (compared with regular clearinghouses such as Change or TriZetto) is that claims sent out via DrChrono to Carisk (fka iHCFA) will include the locked clinical note associated with the appointment. Any unlocked clinical note will not be sent. Clinical notes are required by WC/AA payers when reviewing claims for payment.
If you will be submitting Worker's Comp Claims and need this feature turned on, please reach out to your Account Manager or support and they can assist.
Using Carisk Partners (fka iHCFA)
To submit claims through Carisk to payers, the WC accident payer information (including payer id - listed on the link below) should be completed in the appropriate WC tab under the patient demographics. Filling out as much information as you have will limit the amount of rejections/rework needed in order to get the claim processed and paid.
Only locked clinical notes will be sent to the payer. The claim will still submit if it is not locked, but notes will not be sent. The payer most likely will reject the claim asking for clinical notes. Having it locked prior to submission will eliminate a delay in processing due to the lack of clinical notes.
How to submit a claim through Carisk Partners (fka iHCFA)
Submitting worker's comp claims through Carisk is simple. Just make sure that you've contacted either your Account Manager or Support and have the feature turned on for your account.
Once it is turned on, just fill in the payer information under either the worker's comp tab in the patient's demographic section. Filling out the fields as completely as possible will assist in getting your claim processed without delay.
For each appointment, just make sure the payment profile is listed as "Worker's Compensation" within the patient appointment so the system will know to which tab to pull applicable payer information.
When you are ready for the claim to submit, select Billing Status Worker's Comp Claim, depending on what type of claim you are billing. The claim will be captured and submitted with the next file submission through Carisk Partners (fka iHCFA) to the Worker's Comp payer.
Claim files are submitted to Carisk Partners (fka iHCFA) at 7 pm EST / 4 pm PST 7 days per week, including holidays and/or weekends.
Following a claim through submission
Claims will follow the same process you are used to with medical claims. The log will capture when the claim was submitted to the payer (via a status change to Worker's Comp Claim. Any responses received electronically will appear posted in the appointment as usual. If the payer is not set up to send electronic responses, you will receive a paper remit at the address they have on file for your office.
Receiving payment from the payer
If the payer is set up to send EFT (Electronic Funds Transfer or direct deposit), and you have set it up with them directly, that is how you will receive payment on your claims. If they do not offer the service or if you don't set it up with them, you will receive payment directly from the payer via U.S. postal mail.
Cost to use Carisk Partners (fka iHCFA)
Each claim submission will be charged $1.50.
Other items of interest:
- Carisk (fka iHCFA) can support 2 WC carriers if a patient has multiple work comp injuries that are being sent to different payers.
- Carisk (fka iHCFA) payer list - WC / AA payer list