2018 Average Days to Payment for Facility Bills
Last year, for facility bills submitted through daisyBill payment was received, on average, in 17 days for the top 20 California workers’ comp claims administrators.
Unfortunately, that average exceeds the mandated maximum allowed for bills submitted electronically.
daisyBill’s electronic billing software allows us to comprehensively compile data on every bill we process.
Based on the percentage volume of processed bills through December 31, 2018, the statistics below reflect payment speed -- the average number of business days between the electronic submission of an ambulatory surgery center or other facility bill and receipt of the explanation of review (EOR) -- for the 20 top claims administrators.
In California, Labor Code §4603.4 and the DWC Billing and Payment Guide require claims administrators to process electronic bills within 15 days. This includes facility bills. Only about half of the top-volume claims administrators get it right with processing deadlines, which is disappointing given the compliance achieved with medical treatment and medical-legal bills.
Claims Administrator Payment Speed: Fastest to Slowest
The quickest and slowest claims administrators are identified below by their respective share of the volume of claims processed in 2018:
🐇 Three fastest-paying administrators:
- Gallagher Bassett -- 8.7 days
- Sedgwick CMS & Insurance Company of the West (tie) -- 12.4 days
- ESIS Inc. -- 13.4 days
🐌 Three slowest-paying administrators:
- York Risk Services Group -- 30.5 days
- Tristar Risk Management -- 27.2 days
- Acclamation Insurance Management Services -- 23.3 days
Average Days to Payment - 2018 California Facility Bill Submissions
Claims Administrator |
% Bill Volume |
Average Days |
Tristar Risk Management |
18.3% |
27.2 |
York Risk Services Group |
15.2% |
30.5 |
Sedgwick Claims Management Services |
9.1% |
12.4 |
Gallagher Bassett Services |
6.1% |
8.7 |
State Compensation Insurance Fund (CA) |
5.9% |
15.1 |
Acclamation Insurance Management Services |
4.0% |
23.3 |
CorVel Corporation |
3.0% |
13.5 |
Travelers |
2.6% |
14.6 |
Zurich Insurance North America |
2.1% |
16.9 |
AmTrust North America |
1.8% |
21.5 |
Broadspire |
1.8% |
16.1 |
ESIS, Inc. |
1.8% |
13.4 |
Liberty Mutual Insurance |
1.8% |
15.2 |
Los Angeles County Metropolitan Transit Authority |
1.8% |
16.6 |
Adminsure, Inc. |
1.6% |
14.5 |
Insurance Company of the West |
1.6% |
12.4 |
Athens Administrators |
1.4% |
17.5 |
City of Los Angeles |
1.4% |
18.8 |
Berkshire Hathaway Homestate Companies |
1.1% |
21.3 |
AIG Claims, Inc. |
< 1% |
* |
As our data shows, only about 50% of these administrators are, on average, hitting at or below the mandated maximum. Electronic billing is an efficient means of submitting billing for surgical centers and provides for faster turnaround time for payment. It is our distinct hope that 2019 will see more compliance from the payer side.
daisyBill Payment Data
daisyBill’s electronic billing software compiles data on every facility bill processed for all 300+ claims administrators to which we submit. For any of these claims administrators, use our free online tool to check on its Average Days to Payment. Search and filter by name, submission type, or service type.
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DaisyBill provides content as an insightful service to its readers and clients. It does not offer legal advice and cannot guarantee the accuracy or suitability of its content for a particular purpose.
