Alert: Conduent Faxes Doctor Scam-ish Contract

Alert: Conduent Faxes Doctor Scam-ish Contract

California’s Official Medical Fee Schedule (OMFS) establishes the rates at which claims administrators must pay providers who agree to treat injured workers. But rather than paying a doctor at OMFS rates, Conduent, in cahoots with Third-Party Administrator (TPA) Athens Administrators, faxed the doctor a ‘discount contract’ requesting a massive reimbursement discount.

This Athens-Conduent contract offered the doctor the following:

  1. 80% of the OMFS, instead of 100% as established by California law,
  2. No guarantee of payment; Athens retained the right to deny the bill,
  3. At best, 1 day faster payment than already mandated by California law,
  4. At worst, payment well past the date mandated by California law, and
  5. In the event Athens-Conduent failed to pay the proposed reduced reimbursement, the doctor waives “all penalties and interest/attorney fees” owed for the “referenced dates of service”

That’s it.

Why would any doctor’s authorized representative sign this contract? For the exact same reason any mark falls for a bait-and-switch scheme: the lure of a superficially attractive offer that, in reality, sets a trap for the unwary.  

Below, we document the underhanded way in which Athens-Conduent attempted to hustle one doctor on behalf of The Permanente Medical Group, Inc., a self-insured employer.

Step 1: Create False Urgency

Operating “For and on behalf of Athens Administrators,” Conduent attempted to wring revenue from a daisyCollect client by faxing a two-page contract (we document in a separate article how Conduent also badgered the doctor with telephone calls insisting the doctor accept sub-OMFS rates).

The cover sheet of the faxed discount contract conveyed a manufactured sense of urgency by setting a bolded, arbitrary deadline for the doctor to accept the offer of reduced payment ASAP.

Step 2: Propose Reimbursement Rate of 80% OMFS

It is important to recognize two important facts:

  1. Athens authorized the treatment provided by the doctor.
  2. After treating the injured worker, the doctor sent Athens a bill which listed the rates established by the OMFS (the doctor simply expected to receive payment at OMFS rates, nothing more). 

Yet, the Athens-Conduent duo faxed the doctor a discount contract urgently requesting that the doctor accept a reimbursement $127.65 below OMFS rates. This amount represents only 80% of OMFS rates allowed for this doctor’s treatment of Permanente Medical Group’s injured worker.

Step 3: Offer Payment Date AFTER Mandated Payment Date

Like many workers’ compensation discount contracts, the fine print is deadly.

In exchange for $127.65, the Athens-Conduent duo proposed to pay the doctor within “7-10 business days.” According to this timeline, the earliest date the doctor would receive payment (if the doctor signed immediately) is 5/5/2022. Since the doctor had until 4/29/2022 to sign the contract, payment could have come as late as 5/13/2022 (or even later).

Except, this doctor billed electronically for the services rendered. Therefore, California law mandates Athens must remit payment to the doctor no later than 5/6/2022 (a single day after the earliest date Athens-Conduent proposed to pay the doctor).

Fact: In exchange for $127.65, Athens-Conduent is offering to pay the doctor — at best — a single day earlier than the California-mandated payment deadline.

Step 4: Athens Retains Right to Deny Bill

According to the proposed contract, even if the doctor signs the contract accepting 80% of OMFS reimbursement, signing the contract is not a guarantee of payment, because Athens retains the right to deny the bill.

The contract explicitly states that “Should such bill be determined to be denied or to not be covered [by Athens], this offer shall be null and void.”

Step 5: Athens Retains Right NOT to Pay Quickly

Next, the proposed contract uses particularly opaque language to stipulate that Athens-Conduent does “not guarantee payment earlier than as required” by California law.  

The most generous interpretation of this part of the contract: the provider is signing away $127.65 for the privilege of being paid according to already-existing law. The sole inducement to sign this contract is meaningless; should the provider give another 20% of their reimbursement to Athens-Conduent for meeting other basic requirements, like returning an EOR?

Step 6: Take Away Doctor’s Right to Penalty and Interest

We’ve established that the Athens-Conduent contract guarantees neither payment nor timely payment.

Moreover, in the tiniest print (ever), the proposed contract establishes that in the event Athens-Conduent fails to timely pay the 80% OMFS rate, the doctor waives “all penalties and interest/attorney fees” owed for the “referenced dates of service.”

In other words, this contract allows Athens-Conduent to pay the doctor 80% of OMFS reimbursement in 10 days, 10 months, or 10 years — with no right to penalty and interest for the doctor, and potentially zero repercussions for Athens.

SCAM Defined

By signing this contract gifting Athens-Conduent $127.65, an unwitting doctor’s authorized representative would grant this duo the contractual right to delay payment without penalty, in exchange for accepting 80% of OMFS rates.

We wonder if self-insured employers like The Permanente Medical Group, Inc. are aware of these schemes being implemented by Conduent and Athens on the employer’s behalf.


Protect your practice. daisyBill helps providers get fast, accurate reimbursement for treating injured workers, at state fee schedule rates. Reach out to learn how we can help.


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