Reimbursement Intelligence Platform

Workers' Comp Billing,
Precisely Calculated.

ClaimCalcPro™ is the first B2B SaaS platform to automate workers' compensation reimbursement calculations across every state's regulatory framework — eliminating manual errors, accelerating cash flow, and ending revenue leakage for good.

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50
State Frameworks Covered
15+
Years Domain Expertise
100%
Regulatory Compliance
The Problem

The Hidden Cost of
Manual WC Calculations

Workers' compensation reimbursement is one of the most complex billing environments in healthcare. Every state operates under distinct fee schedules, payment methodologies, and regulatory requirements that change constantly.

Revenue cycle teams are forced to rely on manual processes, static spreadsheets, and fragmented knowledge — costing organizations millions annually in underpayments, write-offs, and compliance exposure.

50 Different Rule SetsEach state has unique fee schedules, modifier logic, and payer policies that must be applied precisely — or payment is lost.
Constant Regulatory ChangeFee schedule updates, legislative changes (GA SB68, LA SB231, AR Act 28), and payer-specific rules shift constantly without warning.
Manual Error & Revenue LeakageSpreadsheet-based workflows produce systematic undercoding, missed modifiers, and preventable denials.
No Purpose-Built SolutionGeneral RCM tools weren't built for WC. ClaimCalcPro was.
Core Capabilities

Built for the Complexity
of Workers' Compensation

⚖️

State-by-State Fee Schedules

Automated application of all 50 states' current fee schedules, including RBRVS-based, resource-based, and proprietary payer methodologies.

🔄

Real-Time Regulatory Updates

Continuously monitored rule sets ensure your calculations always reflect current law — including post-phantom-damages legislative changes.

🎯

Modifier & Payment Logic

Complex modifier hierarchies, multiple procedure reductions, and surgical assistant rules applied automatically and accurately.

🏥

EHR Integration Ready

Native integration modules for Epic, Cerner, Meditech, and major clearinghouses — no manual exports required.

📊

Reimbursement Analytics

Identify underpayment patterns, payer performance trends, and revenue recovery opportunities across your entire WC portfolio.

🔒

HIPAA-Aligned Architecture

Enterprise-grade security with end-to-end encryption, audit logging, and BAA-ready infrastructure built from the ground up.

How It Works

From Claim to Correct Payment
in Four Steps

01

Claim Ingestion

Submit claims via API, direct EHR integration, or secure file upload. ClaimCalcPro parses all relevant data points instantly.

02

State Rule Matching

The platform identifies the applicable state framework, payer, and current fee schedule version for every claim automatically.

03

Precise Calculation

All modifiers, reductions, surgical rules, and payer-specific logic are applied with full audit trail transparency.

04

Actionable Output

Receive expected reimbursement amounts, variance flags, and denial risk scores — ready for billing or appeals workflow.

Coverage

All 50 States.
Zero Gaps.

From California's complex OMFS schedule to Tennessee's employer-directed care model, every jurisdiction is covered and current.

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Who We Serve

Purpose-Built for Revenue
Cycle Professionals

Health Systems & Hospitals

  • Eliminate manual WC billing spreadsheets
  • Reduce underpayment and write-off rates
  • Standardize multi-state WC workflows
  • Accelerate cash collections on WC accounts

RCM Companies & Billing Services

  • Scale WC billing without headcount increases
  • Deliver verifiable accuracy to hospital clients
  • Automate complex multi-state portfolios
  • Differentiate with purpose-built WC expertise

Insurers & Third-Party Administrators

  • Automate WC bill review and repricing
  • Ensure consistent application of state rules
  • Reduce manual review costs per claim
  • Improve audit defensibility and documentation

Legal & LegalTech Firms

  • Access precise WC reimbursement benchmarks
  • Support litigation with defensible calculations
  • Navigate post-phantom-damages billing landscape
  • Quantify damages in WC-related matters
Workers' comp is the most underserved frontier in healthcare revenue cycle. We built the tool we always wished existed.
Melissa Cousin · Founder, ClaimCalcPro™
Leadership

Founded by a
Revenue Cycle Expert

Melissa Cousin — Founder & CEO, ClaimCalcPro™

Melissa Cousin

Founder & CEO · ClaimCalcPro™

With over 15 years of healthcare revenue cycle experience at leading national health systems, large-scale RCM organizations, and specialty revenue recovery firms, Melissa brings unmatched operational depth to every product decision.

Her expertise spans workers' compensation billing, third-party liability recovery, litigation collections, and multi-state regulatory compliance — the exact disciplines that power ClaimCalcPro's precision and reliability.

CRCR Certified · HFMA 15+ Yrs Healthcare RCM WC Regulatory Expert Litigation Collections HIPAA-Aligned Architecture
Book a Demo

Schedule a Personalized
Demo or Consultation

Ready to see how ClaimCalcPro™ can transform your workers' comp reimbursement workflow? Book a 30-minute demo with our team, or reach out directly.

📅 Schedule a 30-Minute Demo on Calendly ✉ admin@claimcalcpro.com ☎ 615.359.5204
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Get Started

Stop Leaving Workers' Comp Revenue on the Table

Request a personalized demo and see exactly how ClaimCalcPro™ transforms your workers' comp reimbursement workflow.

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