Workers’ Compensation Network Solutions

Anthem Workers’ Compensation is one of the industry’s most comprehensive Workers’ Compensation PPO networks committed to meeting clients’ needs by providing best-in-class PPO network savings and accessibility. AWC is dedicated to the administration of Workers’ Compensation care by providing access to appropriate and quality medical care to injured workers and giving self-insured employers, TPAs and insurance carriers the power to better manage their workers’ compensation costs and benefits.

Available in California, Colorado, Illinois, Indiana, Missouri, and Nevada. AWC can serve as the single point of contact for launching a Workers’ Compensation network program in multiple states.

The Anthem Workers’ Compensation Difference
Workers’ Compensation PPO Networks

• Physician/hospital expertise and accountability are key benchmarks of AWC’s proven PPO networks.
• Repricing options streamline the claims administration process.
• Competitive, contracted PPO network rates and actuarial analyses of medical cost trends.
• Full range of providers (primary treating physicians, occupational clinics, specialists, facilities) credentialed according to NCQA standards.
• Quality Assurance department staffed by clinical and non-clinical personnel focused on resolution of Provider issues.
• Web-based tools – provider finder, customizable directories, customizable MPNs.

Electronic PPO Pricing

• Customer completes initial pricing to state fee schedule or U&C database and submits bill for PPO pricing.
• All bills go to Anthem Workers’ Compensation to maximize PPO penetration.
• Supports fully secure, encrypted ANSI Standard 837-file submission.
• Allows pre- and post-edits to ensure a clean bill the first time. No lost or pended bills.
• Includes application of any lesser of PPO and fee schedule language per provider contracts.
• Supports request for re-evaluation when PPO rate is at issue.
• Works closely with the Bill Review agent or Carrier to ensure maximum PPO network value.

Analytic Advantage

• AWC provides clients a full range of consultative reporting solutions designed to keep you one step ahead of fluctuating workers’ compensation trends.
• Our state-of-the-art analytical tools extract information from your organization’s data to deliver actionable results that save you money and increase your workflow efficiency.

Anthem Workers’ Compensation – Workers’ Compensation Experts

• Full-time staff of Workers’ Compensation professionals, including a National Medical Director, clinical and non-clinical Quality Assurance personnel.
• Toll-free Customer Service with dedicated Workers’ Compensation experts.

Anthem Workers’ Compensation