The Full Claim Journey

An end-to-end trace mapping the programmatic operational milestone states of an active file.

01

Patient Admission

Your Injury on Duty (IOD) patient is received at intake. Your clinical practitioners execute diagnostic evaluations and standard clinical treatments exactly as normal.

02

Primary Metrics Capture

Your front desk logs primary anchor datasets: validated national identification, verified employer registration criteria, precise incident dates, and clear clinical summaries.

03

Ecosystem Ingestion

Files route instantly into our tracking queues. Submit smoothly through the dedicated NovelSwitch web portal, encrypted batch channels, or direct billing exports.

04

Audit Gate

Registration Verification

We audit active CompEasy profiles to verify the employer logged the incident correctly. If registration is missing, our team intervenes upstream to resolve the roadblock.

05

Optimization & Coding

Our specialists map medical parameters onto optimized ICD-10 sets and exact gazette tariffs, pairing clean W.Cl.4 or W.Cl.5 reports onto the standardized invoice frame.

06

Formal Fund Transmission

The optimized file transmits securely through relevant gateway endpoints—CompEasy, RMA, or FEM. Ingestion points are logged with unalterable digital time-stamps.

07

High-Frequency Tracking

We actively monitor the pipeline state. Systemic queries trigger immediate same-day remediations. Portals crossing day 60 trigger immediate statutory W.Cl.20 enquiry actions.

08

Ledger Clearing

Cleared capital drops straight into your practice bank accounts. We provide a transparent monthly reconciliation statement identifying outstanding entries and paid balances cleanly.

Division of Responsibilities

A clear separation between your clinical delivery and our administration.

Clinical Focus (Your Team)

• Execute standard clinical patient healthcare and interventions

• Formulate accurate primary and progressing medical files

• Capture standard identifying patient data sets at intake desk

• Provide final executive authorization updates on compiled files

Operations Engine (Our Team)

✓ Audit external employer registration records inside systemic layers

✓ Apply complex statutory gazette tariff mechanics and ICD-10 structures

✓ Structure, pack, and drop clean claims to CompEasy, RMA, and FEM

✓ Run continuous micro-tracking on individual pipeline entry paths

✓ Remediate unexpected file exceptions on the same business day

✓ Deploy formal legal W.Cl.20 administrative enquiry actions at day 60

✓ Perform clear reconciliation accounting to clear out legacy backlog logs

✓ Provide clean, data-backed operational overviews on fixed schedules

Turnaround Estimates

The ultimate payment timeline resides with external state institutions. Our responsibility centers on ensuring transmission remains optimized, clean, and aggressively tracked.

Transmission of complete patient submissions

Within 48 hours

Initial institution system acceptance receipt

5 to 14 days

Average statutory processing timeline turnaround

~90 days post-acceptance

Administrative query response mapping execution

Same business day

Structural rejection correction and re-drop

5 to 10 working days

Ready to clear your pipeline bottlenecks?

Schedule a dedicated operational trace. We will outline processing options using real metrics from your current pending files.

Schedule a Technical Consultation

How it works