How else can we put this? Sometimes ESIS, a Third-Party Administrator (TPA), just flat-out ignores bills for Medical-Legal services.
Below, daisyBill documents how ESIS is in violation of California law (to say nothing of the basic principles of commerce generally) by failing to timely issue payment for ten Medical-Legal evaluations. daisyBill submitted formal Audit Complaints to the Division of Workers’ Compensation (DWC) reporting the ten unpaid bills.
Qualified Medical Evaluators (QMEs) and Agreed Medical Evaluators (AMEs), check your Accounts Receivables for unpaid ESIS bills. To receive payment for performing Medical-Legal evaluations, daisyBill experience indicates that providers must call (and call and call) to get the ESIS adjuster to release payment.
These are not disputes over liability or the amounts owed; it is simply a case of ESIS’ receiving bills…and admittedly doing nothing. Sometimes indefinitely.
We urge the DWC to demonstrate that there is a limit to the level of disregard for the law that California is willing to tolerate.