CA 2022 Data: Claims Admin Days to Payment
The numbers are in!
2022 data prove once again that electronic billing slashes the time it takes for providers to get paid for treating injured workers in California (as long as claims administrators adhere to the law).
Below we list the 149 claims administrators to which daisyBill providers sent 100 or more bills in 2022, with average days to payment for each.
The majority of claims administrators honored the 15-working-day deadline to remit payment for medical treatment; some maintained even faster than required average days to payment — even for non-medical services not subject to the 15-day time frame (i.e. Medical-Legal, copy, and interpreter services).
However, too many claims administrators continue to flout the law, either failing to accept e-bills, or far exceeding the mandatory deadlines.
California regulators and legislators, take note: we are keeping score. Employers, providers, and injured workers deserve a system where accountability is the expectation.
The law is clear: California Labor Code Section 4603.4(d) states:
“Payment for medical treatment provided or prescribed by the treating physician selected by the employee or designated by the employer shall be made with an explanation of review by the employer within 15 working days after electronic receipt of an itemized electronic billing…”[emphasis added]
Fastest Days to Pay 2022
Some claims administrators did a better job than others at adhering to the unambiguous legal requirement above. For example, in 2022 the 6 claims administrators below reimbursed providers, on average, in less than a week for all original bills — including non-medical bills not subject to the 15-day requirement.
If these claims administrators can pay this quickly, all claims administrators can, at minimum, meet the legal requirements.
Claims Administrator - 2022 (Biggest) Winners |
Avg Working Days to Pay |
Total Bill Count 2022 |
Alaska National Insurance |
4 |
5,094 |
Mitsui Sumitomo Insurance |
5 |
1,519 |
Sentry Insurance |
6 |
11,467 |
Adminsure, Inc. |
6 |
18,275 |
Omaha National Group |
6 |
4,283 |
Innovative Claim Solutions, Inc. |
6 |
2,062 |
Honorable mentions also go to CorVel and Travelers, both of which paid relatively high volumes of e-bills (48,594 e-bills for CorVel; 38,233 e-bills for Travelers) in an average 7 days in 2022, for all service types. This is precisely how e-billing is supposed to work!
Slowest Days to Pay 2022
On the other end of the spectrum, the dozen claims administrators below were the slowest, with self-insured employer Loma Linda University taking an average 81 days to remit payment and the Explanation of Review (EOR) to the provider for all service types:
Claims Administrator - 2022 (Biggest) Losers |
Avg Working Days to Pay |
Total Bill Count 2022 |
Loma Linda University |
81 |
306 |
Creative Risk Solutions |
49 |
623 |
Affirmative |
45 |
1,686 |
Innovative Claims Strategies, LLC |
30 |
215 |
Marriott Claims Service Corp |
25 |
3,537 |
Cottingham & Butler Claim Services, Inc. |
23 |
2,193 |
Salus |
21 |
259 |
Hazelrigg Claims Management Services |
21 |
312 |
Nassco / General Dynamics |
21 |
2,660 |
ClaimQuest, Inc. |
20 |
458 |
Matrix Absence Management |
20 |
1,631 |
Risico Claims Management, Inc. |
20 |
1,982 |
Perhaps most frustratingly, certain public California employers failed to adhere to California law and took excessive amounts of time to reimburse providers:
Claims Administrator - 2022 (Public-Sector) Losers |
Avg Working Days to Pay |
Total Bill Count 2022 |
County of San Bernardino |
30 |
1,614 |
County of Sacramento |
20 |
638 |
City of Torrance |
25 |
512 |
City of Santa Monica |
48 |
503 |
City of Burbank |
24 |
285 |
City of Riverside |
24 |
154 |
The 6 counties and cities above should take a page from an exemplary public employer, the City of Los Angeles, which in 2022 paid 6,849 e-bills from daisyBill in an average 8 days (huge kudos to LA — a public-sector winner!).
2022 CA Average Days to Payment
The table below lists all claims administrators to which California providers sent 100 or more bills via daisyBill.
A few important notes:
-
Some of the claims administrators below fail to accept e-bills, despite California law mandating e-bill acceptance. As a result, daisyBill is forced to fax or email bills to these claims administrators.
We include these claims administrators on the list because it is not the providers’ (or daisyBill’s) choice to send paper bills; it is the result of non-compliance by these claims administrators, which are under no less obligation to remit timely payment than any other.
- The 15-working-day deadline to remit payment and the EOR applies only to e-bills for medical and facility treatment. Bills for Medical-Legal, copy, and interpreter services are not subject to the 15-working-day deadline.
However, we include the average days to payment for these services (both in the overall average days to payment, and in separate columns for each service type) to demonstrate how, even when not mandatory, e-billing reduces billing friction and speeds payment. - The data below refer only to original bills, not bills resubmitted as Second Review appeals.
- All payment speed averages use verifiable dates provided by the claims administrators in the mandatory electronic EORs sent in response to e-bills. For the non-compliant claims administrators that fail to accept e-bills or send e-EORs, payment dates are provided by providers’ administrative staff (and are not verifiable).
Finally, daisyBill would like to offer a special nod of approval to LWP Claims Solutions and its bill review vendor, Accuro Solutions.
daisyBill exposed consistent and egregious e-billing non-compliance by LWP in 2022, ultimately filing thousands of formal Audit Complaints with the Division of Workers’ Compensation (DWC). In response, the professionals at Accuro reached out to daisyBill for help with improving LWP’s compliance.
As a result of both companies’ sincere efforts, LWP’s average days to payment for all service types fell by over half, to a December average of 10 days from a high of 21 days in January.
While LWP’s overall 2022 average of 18 days to payment still fell short of California requirements, it is a massive and much-appreciated improvement. On behalf of providers and injured workers, we commend LWP and Accuro for taking the necessary action to make workers’ comp work better for providers and injured workers.
2022 Original Bill Count by Fee Schedule |
Medical Tx
|
Facility
|
Medical-Legal
|
Copy Service
|
Interpreter Service
|
||
Total Original Bill Count |
1,178,314 |
9,712 |
113,034 |
102,356 |
25,159 |
||
Claims Administrator |
Avg Working Days to Pay |
2022 Original Bill Count |
Avg Days to Pay |
Avg Days to Pay |
Avg Days to Pay |
Avg Days to Pay |
Avg Days to Pay |
Sedgwick Claims Management Services |
10 |
287,699 |
10 |
12 |
12 |
8 |
10 |
State Compensation Insurance Fund (CA) |
11 |
116,815 |
11 |
10 |
14 |
9 |
3 |
Gallagher Bassett |
7 |
99,806 |
7 |
9 |
9 |
6 |
7 |
Liberty Mutual Insurance |
7 |
52,712 |
7 |
6 |
6 |
6 |
5 |
Berkshire Hathaway Homestate Companies |
9 |
51,580 |
9 |
13 |
10 |
32 |
22 |
Intercare Holdings Insurance, Inc. |
10 |
50,274 |
10 |
13 |
10 |
10 |
12 |
CorVel |
7 |
48,594 |
7 |
8 |
7 |
7 |
9 |
Zurich Insurance North America |
10 |
45,657 |
11 |
13 |
9 |
8 |
9 |
ESIS, Inc. |
14 |
42,716 |
13 |
14 |
25 |
14 |
15 |
Travelers |
7 |
38,233 |
6 |
7 |
9 |
15 |
10 |
Broadspire |
9 |
36,438 |
10 |
11 |
8 |
6 |
8 |
Insurance Company of the West |
10 |
31,461 |
10 |
14 |
10 |
8 |
12 |
Athens Administrators |
14 |
27,676 |
14 |
13 |
15 |
13 |
19 |
Tristar Risk Management |
14 |
26,521 |
13 |
15 |
19 |
28 |
30 |
Cannon Cochran Management Services Inc. |
16 |
26,254 |
16 |
16 |
18 |
18 |
18 |
AmTrust North America |
15 |
25,931 |
16 |
17 |
14 |
11 |
17 |
Keenan & Associates |
9 |
21,710 |
10 |
9 |
7 |
8 |
10 |
Department of Labor |
9 |
18,716 |
9 |
- |
- |
- |
- |
Adminsure, Inc. |
6 |
18,275 |
6 |
8 |
7 |
6 |
6 |
The Zenith |
10 |
16,122 |
9 |
15 |
23 |
8 |
6 |
Los Angeles County Metropolitan Transit Authority (CA) |
13 |
16,031 |
13 |
17 |
14 |
13 |
14 |
Helmsman Management Services |
7 |
14,441 |
8 |
6 |
6 |
6 |
5 |
The Hartford |
14 |
13,090 |
14 |
8 |
12 |
22 |
17 |
Acclamation Insurance Management Services |
13 |
12,760 |
13 |
14 |
14 |
15 |
13 |
Employers Compensation Insurance Company |
11 |
12,080 |
10 |
8 |
10 |
26 |
43 |
Next Level Administrators |
9 |
12,036 |
9 |
12 |
12 |
6 |
8 |
Sentry Insurance |
6 |
11,467 |
6 |
5 |
5 |
3 |
5 |
Republic Indemnity |
8 |
11,115 |
7 |
11 |
10 |
10 |
10 |
Chubb Group of Insurance Companies |
11 |
10,996 |
11 |
11 |
14 |
12 |
11 |
Pacific Compensation Insurance Company |
8 |
10,614 |
8 |
10 |
7 |
32 |
24 |
CompWest Insurance Company |
12 |
9,344 |
13 |
12 |
10 |
12 |
10 |
Benchmark Insurance Company |
11 |
7,626 |
11 |
14 |
14 |
11 |
12 |
Farmers Insurance |
7 |
7,617 |
7 |
9 |
6 |
7 |
5 |
Preferred Employers Insurance Company |
7 |
7,466 |
7 |
8 |
8 |
14 |
4 |
LWP Claims Solutions |
18 |
7,354 |
18 |
19 |
20 |
21 |
25 |
City of Los Angeles (CA) |
8 |
6,849 |
8 |
14 |
11 |
7 |
14 |
American Claims Management, Inc |
10 |
5,651 |
10 |
12 |
10 |
10 |
13 |
Guard Insurance Group |
9 |
5,629 |
8 |
10 |
11 |
10 |
8 |
City of San Diego (CA) |
11 |
5,624 |
11 |
13 |
13 |
8 |
- |
CNA Insurance |
9 |
5,283 |
9 |
15 |
10 |
8 |
9 |
Alaska National Insurance |
4 |
5,094 |
4 |
5 |
4 |
4 |
6 |
Beta Healthcare Group Risk Management Authority |
10 |
4,719 |
10 |
9 |
10 |
8 |
10 |
Albertsons / Safeway / Vons |
9 |
4,643 |
9 |
14 |
10 |
33 |
7 |
City and County of San Francisco (CA) |
9 |
4,296 |
9 |
10 |
10 |
10 |
- |
Omaha National Group |
6 |
4,283 |
6 |
6 |
6 |
- |
31 |
Pacific Claims Management |
18 |
3,718 |
18 |
14 |
21 |
23 |
36 |
County of Santa Clara (CA) |
8 |
3,692 |
8 |
10 |
13 |
7 |
10 |
Marriott Claims Service Corp |
25 |
3,537 |
25 |
20 |
22 |
12 |
22 |
County of San Diego (CA) |
11 |
3,274 |
11 |
14 |
10 |
5 |
- |
Enstar Group |
10 |
3,262 |
10 |
10 |
9 |
7 |
11 |
California Insurance Guarantee Association |
23 |
3,009 |
23 |
13 |
24 |
20 |
18 |
AmeriTrust Group, Inc. |
13 |
3,003 |
13 |
14 |
13 |
13 |
16 |
Strategic Comp |
9 |
2,828 |
9 |
10 |
9 |
9 |
8 |
Midwest Insurance |
18 |
2,762 |
18 |
19 |
17 |
29 |
38 |
Markel First Comp Insurance |
11 |
2,703 |
11 |
11 |
12 |
8 |
10 |
Nassco / General Dynamics |
21 |
2,660 |
21 |
18 |
14 |
- |
- |
Elite Claims Management |
9 |
2,634 |
9 |
15 |
13 |
- |
30 |
Crum & Forster |
13 |
2,615 |
13 |
14 |
14 |
14 |
11 |
Protective Insurance |
9 |
2,311 |
9 |
11 |
12 |
8 |
8 |
Sempra Energy Employee Care Services |
10 |
2,217 |
10 |
10 |
9 |
7 |
- |
Cottingham & Butler Claim Services, Inc. |
23 |
2,193 |
23 |
17 |
23 |
16 |
15 |
Self-Insured Schools of California (CA) |
9 |
2,135 |
9 |
11 |
10 |
13 |
10 |
Sutter Health |
9 |
2,092 |
10 |
9 |
9 |
14 |
- |
Innovative Claim Solutions, Inc. |
6 |
2,062 |
6 |
8 |
8 |
- |
22 |
Allianz |
11 |
2,057 |
11 |
17 |
10 |
10 |
11 |
City of Los Angeles Department of Water and Power (CA) |
18 |
2,012 |
18 |
20 |
18 |
22 |
21 |
Risico Claims Management, Inc. |
20 |
1,982 |
20 |
19 |
20 |
28 |
29 |
WCF Insurance |
16 |
1,952 |
17 |
17 |
16 |
15 |
16 |
Applied Underwriters |
14 |
1,743 |
13 |
17 |
18 |
32 |
18 |
Affirmative |
45 |
1,686 |
44 |
28 |
45 |
23 |
79 |
GuideOne Insurance |
8 |
1,677 |
8 |
8 |
9 |
8 |
7 |
Matrix Absence Management |
20 |
1,631 |
20 |
16 |
24 |
38 |
27 |
County of San Bernardino (CA) |
30 |
1,614 |
31 |
21 |
26 |
- |
- |
Pacific Gas & Electric |
11 |
1,612 |
11 |
11 |
12 |
10 |
- |
Hanover Insurance Company |
8 |
1,587 |
8 |
12 |
9 |
9 |
8 |
Berkley Net Underwriters, LLC |
15 |
1,559 |
14 |
11 |
24 |
18 |
16 |
Garden Grove Unified School District (CA) |
13 |
1,522 |
13 |
- |
18 |
11 |
13 |
Mitsui Sumitomo Insurance |
5 |
1,519 |
5 |
9 |
6 |
5 |
5 |
County of Riverside (CA) |
12 |
1,491 |
11 |
12 |
15 |
- |
- |
Contra Costa County Schools Insurance Group (CA) |
11 |
1,398 |
12 |
10 |
10 |
11 |
9 |
National Interstate Insurance |
16 |
1,398 |
16 |
19 |
18 |
36 |
13 |
PMA Companies |
16 |
1,356 |
16 |
10 |
11 |
21 |
16 |
American Equity Underwriters |
9 |
1,346 |
8 |
6 |
15 |
16 |
10 |
JT2 Integrated Resources |
15 |
1,343 |
15 |
18 |
17 |
- |
19 |
Church Mutual Insurance Company |
10 |
1,273 |
10 |
17 |
11 |
7 |
16 |
Charles Taylor TPA |
11 |
1,232 |
11 |
13 |
15 |
22 |
- |
Subsequent Injuries Benefits Trust Fund (CA) |
34 |
1,199 |
65 |
- |
33 |
35 |
44 |
Pegasus Risk Management Services |
7 |
1,147 |
7 |
6 |
8 |
6 |
- |
Disneyland Resorts California |
10 |
1,076 |
9 |
13 |
14 |
- |
8 |
Contra Costa County Risk Management (CA) |
13 |
1,055 |
13 |
13 |
13 |
10 |
10 |
Fresno Unified School District (CA) |
7 |
995 |
7 |
7 |
6 |
8 |
10 |
Intact Insurance Specialty Solutions |
11 |
992 |
12 |
10 |
12 |
7 |
4 |
United Heartland |
11 |
971 |
11 |
11 |
10 |
17 |
12 |
Nordstrom Workers' Compensation |
10 |
938 |
10 |
10 |
9 |
- |
13 |
Southern California Edison |
10 |
896 |
10 |
16 |
11 |
- |
- |
Tokio Marine Management |
12 |
814 |
12 |
13 |
25 |
13 |
8 |
Packard Claims Administration |
12 |
806 |
12 |
7 |
12 |
17 |
15 |
Berkley Specialty Underwriting Managers |
8 |
714 |
9 |
8 |
8 |
6 |
17 |
National Liability and Fire Insurance Company |
10 |
705 |
8 |
8 |
10 |
10 |
26 |
Workers' Compensation Administrators, LLC |
8 |
701 |
8 |
11 |
11 |
- |
- |
Schools Insurance Authority (CA) |
10 |
651 |
9 |
12 |
10 |
- |
16 |
County of Sacramento (CA) |
20 |
638 |
20 |
- |
24 |
- |
- |
Nationwide Insurance Companies |
14 |
629 |
14 |
30 |
10 |
21 |
14 |
Creative Risk Solutions |
49 |
623 |
50 |
25 |
35 |
34 |
36 |
CopperPoint Mutual |
8 |
542 |
8 |
12 |
10 |
- |
8 |
City of Long Beach (CA) |
13 |
522 |
12 |
13 |
18 |
5 |
- |
City of Torrance (CA) |
25 |
512 |
23 |
41 |
38 |
- |
- |
City of Santa Monica (CA) |
48 |
503 |
51 |
30 |
24 |
- |
- |
Nationwide Agribusiness Companies |
16 |
501 |
16 |
8 |
11 |
13 |
22 |
Municipal Pooling Authority (CA) |
17 |
488 |
17 |
11 |
17 |
21 |
- |
QBE North American |
16 |
477 |
15 |
- |
19 |
12 |
7 |
North Bay Schools Insurance Authority (CA) |
12 |
475 |
12 |
18 |
12 |
13 |
15 |
Constitution State Services |
8 |
474 |
8 |
- |
10 |
9 |
13 |
ClaimQuest, Inc. |
20 |
458 |
20 |
- |
20 |
- |
28 |
Contract Claims Services Inc. |
10 |
435 |
9 |
4 |
193 |
- |
- |
Brotherhood Mutual Insurance |
10 |
425 |
11 |
- |
8 |
5 |
- |
Association of California Water Agencies JPIA |
14 |
402 |
14 |
12 |
14 |
- |
28 |
ARGO - Argonaut Insurance Company |
13 |
400 |
12 |
14 |
13 |
9 |
22 |
National Casualty Company |
10 |
395 |
10 |
23 |
13 |
14 |
11 |
City of Sacramento (CA) |
14 |
358 |
13 |
- |
12 |
18 |
- |
The Cities Group |
19 |
313 |
19 |
- |
19 |
- |
- |
Hazelrigg Claims Management Services |
21 |
312 |
20 |
13 |
23 |
- |
46 |
Loma Linda University (CA) |
81 |
306 |
103 |
- |
12 |
- |
- |
Redwood Empire Schools Insurance Group (CA) |
8 |
287 |
8 |
- |
8 |
7 |
14 |
City of Burbank (CA) |
24 |
285 |
25 |
4 |
22 |
11 |
- |
Murphy and Beane |
17 |
281 |
17 |
10 |
18 |
- |
8 |
Midwestern Insurance Alliance |
16 |
278 |
15 |
13 |
26 |
- |
6 |
City of Glendale (CA) |
15 |
273 |
15 |
17 |
17 |
- |
5 |
Salus |
21 |
259 |
21 |
30 |
27 |
- |
- |
City of Anaheim (CA) |
14 |
242 |
14 |
13 |
14 |
3 |
34 |
Florists Mutual Insurance Company |
7 |
224 |
7 |
- |
6 |
6 |
4 |
Ryder Services Corp |
11 |
219 |
10 |
13 |
16 |
9 |
17 |
Innovative Claims Strategies, LLC |
30 |
215 |
30 |
- |
36 |
- |
- |
Innovative Risk Management |
9 |
211 |
8 |
7 |
12 |
17 |
24 |
California Fair Services Authority |
17 |
211 |
17 |
18 |
15 |
- |
18 |
Gallo Wine Claims |
14 |
210 |
14 |
10 |
15 |
53 |
- |
Trindel Insurance Fund |
10 |
208 |
10 |
- |
19 |
37 |
- |
AccidentFund |
9 |
203 |
9 |
- |
14 |
8 |
7 |
City of San Jose (CA) |
11 |
203 |
11 |
11 |
10 |
12 |
11 |
Vanliner Insurance Company |
16 |
203 |
16 |
13 |
14 |
- |
- |
Sierra Pacific Industries |
14 |
190 |
14 |
- |
17 |
- |
- |
Finish Line Self Insurance Group |
24 |
162 |
20 |
- |
33 |
- |
- |
Maine Employers Mutual Indemnity Company |
7 |
161 |
7 |
- |
8 |
8 |
7 |
Amerisure |
19 |
160 |
18 |
24 |
23 |
- |
- |
City of Riverside (CA) |
24 |
154 |
24 |
- |
24 |
- |
- |
North American Risk Services |
16 |
149 |
16 |
- |
16 |
32 |
10 |
Alternative Service Concepts |
15 |
124 |
14 |
- |
16 |
6 |
23 |
OccuSure Claims Services |
8 |
114 |
7 |
- |
15 |
- |
6 |
SafeCo Insurance |
15 |
106 |
15 |
4 |
16 |
- |
6 |
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