Earlier this year, AIG Claims, Inc. (AIG) made the switch to Carisk as its workers’ compensation electronic clearinghouse. However, and unfortunately, this change had no impact on the long-standing refusal by AIG to comply with California e-billing regulations regarding explanations of review (EORs).
California regulations require clams administrators (aka payers, insurers, carriers) to return providers an electronic EOR within 15 working days of accepting an electronic bill. Nonetheless, in 2020, AIG has so far failed to return over 11,000 electronic EORs to DaisyBill’s California providers. Instead, AIG sends these providers paper EORs.
AIG simply defies California regulations, with apparently no concern that its flouting of regulations will be in any way punished or even acknowledged. While other claims administrators adhere to the rules, AIG sticks out its corporate tongue and blows raspberries at California providers.
What’s Good for the AIG Goose
In the current circumstances of a floundering mail system and the remote working challenges of the COVID-19 pandemic, electronic EORs are not only a legal requirement, they are also an imperative for provider billing staff who already struggle to manage workers’ comp bills.
It is particularly infuriating that AIG benefits from the efficiencies of receiving an electronic bill from providers, while AIG robs providers of the similar efficiencies of receiving an electronic EOR from AIG.
When a provider receives an electronic EOR, the EOR data is automatically posted to the associated electronic bill. AIG’s noncompliance forces providers’ billing staff to manually post the paper EORs sent by AIG rather than receiving the benefits of technology. Equally important, without electronic EORs it is easier for AIG to obscure whether it is complying with California’s timely payment requirements.
Audit Complaints Filed With DWC
In response to AIG’s noncompliance, DaisyBill providers are filing Audit Complaints* with the California Division of Workers’ Compensation (DWC). We urge similarly affected practices and billing services to also file Audit Complaints, using a complaint reason similar to the one below.
*NOTE: The Audit Complaint form was updated in 2019. Access the updated form here: https://www.dir.ca.gov/dwc/Auditref.pdf