Carisk Partners (fka iHCFA) is a clearinghouse specifically used to bill out claims only to Workers' 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. Any unlocked clinical note will not be sent. Clinical notes are required by WC/AA payers when reviewing claims for payment.
The ability to bill through Carisk Partners (fka iHCFA) is not enabled by default for all our customers. We activate it only for the customers who request it.
Activating Carisk Partners (fka iHCFA) for a provider
- Access the doctor’s account and click on Doctor Settings. Check the box and click on Update Doctor Info.
This will enable the Carisk (fka iHCFA) feature in the doctor’s account. You can verify that it is turned on for all providers by going to Swords > Quick View > Providers. There should be a green check box listed in the iHCFA column for each provider that has it turned on.
If multiple providers within the office need the ability to send WC/AA claims through Carisk (fka iHCFA), it will need to be enabled within each provider's account.
Using Carisk Partners (fka iHCFA)
Providers should be instructed that to use Carisk (fka iHCFA), they need to enter the WC/AA accident payer information (including payer ID - listed on the link below) in the appropriate WC/AA tabs under the patient demographics. The fields should be filled out as completely as possible. Doing so will limit the number of rejections/rework needed by the billing team to get the claim processed and paid.
Also, providers should be aware that only locked clinical notes will be sent to the payer. There is no way around this; it is by design. The claim will still be submitted 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 before submission will eliminate a delay in processing due to a lack of clinical notes.
How to submit a claim through Carisk Partners (fka iHCFA)
Submitting worker's comp and/or auto accident 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 and/or auto accident 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" or "Auto Accident" so the system will know to which payer to send the claim.
When you are ready for the claim to submit, select Billing Status Worker's Comp Claim or Auto Accident 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 or Auto Accident payer.
Cost to use Carisk Partners (fka iHCFA)
Each claim will be charged $1.50 for all non-Apollo Plus customers. For Apollo Plus customers, DrChrono absorbs the cost of their WC/AA claim submissions.
Claims Submission
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 or Auto Accident Claim). Any responses that are 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.
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