In the prior installment of this troubling story, a Corvel Senior WC Specialist became belligerent in response to a provider’s inquiry about payment for six bills for psych treatment that CorVel authorized.

What happened next would be unbelievable were it not thoroughly documented.

A defense attorney representing CorVel sent the practice three emails in which he repeatedly disregarded California law regarding payment for authorized treatment. Even worse, the attorney used erroneous, irrelevant legalese to belittle and intimidate the practice’s Collections Representative and Office Manager.  

These emails show a completely unwarranted, aggressive response from CorVel representatives to a provider’s staff, simply for seeking payment for authorized treatment — which should raise concern about how CorVel treats injured workers.

Defense Attorney Email #1: California Law Refresher Needed

Following the testy exchange detailed in our previous article, the Managing Partner of the law firm representing CorVel sent an email denying payment for the authorized treatment and warning the practice not to contact CorVel.  

In this (frankly shocking) email, the CorVel attorney:

1. Erroneously refers to the bills as a “lien” — the practice had not filed a lien, only requested payment.
2. Erroneously labels the treatment as “self-procured” — CorVel authorized the treatment.
3. Reiterates the irrelevant argument that CorVel denies liability for the (very much authorized) psych treatment.
4. Threatens legal action if the practice contacts CorVel again seeking payment for authorized treatment.

Despite the erroneous legal gumbo proffered by this attorney, California law had zero influence on CorVel’s refusal to pay this provider. As a reminder, California law requires CorVel to pay providers for the services CorVel authorizes. Per California Labor Code § 4610.3 (emphasis added):

(a) Regardless of whether an employer has established a medical provider network pursuant to Section 4616 or entered into a contract with a health care organization pursuant to Section 4600.5, an employer that authorizes medical treatment shall not rescind or modify that authorization after the medical treatment has been provided based on that authorization for any reason...

Defense Attorney Email #2: CA Law Fantasy

In an email response, the practice’s Collections Representative provided the CorVel attorney the following facts:

• No lien was at issue.
• The treatments in question were not self-procured by the injured worker.
• The practice possessed documentation proving CorVel authorized the treatment.

However, this dogged (if supremely uninformed) Managing Partner was not deterred by law or facts.

In a response that can be charitably characterized as unprofessional, the attorney continued to rant about CorVel’s alleged lack of liability for psych treatment. (Once more for the cheap seats: liability has no bearing on authorization for services rendered, something an attorney in the workers’ comp space might be expected to know).

The attorney's second email opines how California law should work in his uninformed opinion (i.e., authorization should not guarantee payment) rather than acknowledging how it actually works (i.e., authorization guarantees payment).

Defense Attorney Email #3: “See You At Court”

At this point, the practice’s Office Manager stepped in, insisting (with the restraint and professionalism apparently in short supply over at David Jane & Associates) that CorVel approved the treatment in question. Further, CorVel knew about the treatment.

The Managing Partner lashed out a third time with a “see you at court” message littered with the all-caps ravings of a person profoundly in need of a hug.

Legal Fact: Authorization Guarantees Payment

Contrary to the CorVel defense attorney's assertions that CorVel is not required to pay for authorized treatment, a single fact of law remains inescapable: a claims administrator’s authorization of treatment is the “assurance that appropriate reimbursement for treatment specified will be paid.”

For a TPA and its legal representatives to subject a provider’s staff to this kind of treatment simply for inquiring about bill payments is not just tragic. It is emblematic. Why should providers who treat injured workers (and their staff) fight for payment at practice expense and also endure this type of abject disrespect?

It can be difficult enough to justify treating injured workers financially. This exchange reveals that California workers’ comp providers must also consider the consequences of subjecting their employees to the kinds of behavior CorVel and its representatives exhibited.

We make treating injured workers easier, faster, and less costly. Request a free demonstration below.

REQUEST DEMO