CA 2022 Data: Claims Admin Days to Payment

February 1, 2023 11 min read

By: the daisyNews Team

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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