Currently, California providers do not have a clear way to obtain reimbursement for treatment furnished to injured employees of aerospace and defense company Lockheed Martin.

Previously ESIS, a Third-Party Administrator (TPA), administered and paid Lockheed claims. Effective February 1, 2024, Gallagher Bassett (a different TPA) became Lockheed's new claims administrator.

However, Gallagher Bassett currently denies bills for Lockheed injured workers, including bills submitted after February 1. As of March 11, 2024, Gallagher Bassett representatives report that they do not have claims data for Lockheed employees.

As a reminder, while switching TPAs is not an unusual event, the payment chaos to which Gallagher Bassett is subjecting providers is not an isolated occurrence.

Bottom line: A significant California employer is failing to reimburse providers for treating its employees. Accordingly, providers should proceed cautiously when treating Lockheed Martin’s injured workers.

Lockheed Martin: Leaving Providers Without Pay

Agents of daisyCollect were first alerted to the problem when ESIS denied payment on bills sent for Lockheed injured employees.

As the screenshots from the daisyBill application below show, ESIS began denying payment for Lockheed bills after February 2024. In each instance, ESIS claimed the patients “cannot be identified as our insured” as the reason for the payment denials.

Soon enough, a daisyBill provider received word from Genex (which conducted Utilization Review for Lockheed employees) that all Requests for Authorization should be submitted to Gallagher Bassett.

daisyBill contacted Gallagher Bassett, representatives of which confirmed that Lockheed bills should be sent to Gallagher Bassett effective February 1, 2024.

However, Gallagher Bassett also denied providers’ bills for Lockheed employees, as shown below, for the same reason as ESIS: “Patient cannot be identified as our insured.” The e-bill below was sent on February 27, 2024 — well after the February 1 effective date of the TPA switch.

As of this writing, both ESIS and Gallagher Bassett deny bills for Lockheed’s injured workers, leaving providers no way to be reimbursed.

On March 11, 2024, when daisyBill contacted Gallagher Bassett, representatives confirmed they could not find the claims data necessary to process bills for Lockheed Martin employee claims.

Lockheed Martin: Self-Insured Status Revoked

As of January 22, 2024, an Explanation of Review (EOR) sent by ESIS listed Lockheed as the “Carrier,” indicating that Lockheed is a self-insured employer.

But strangely, according to its website, the California Office of Self-Insured Plans (OSIP) revoked Lockheed Martin Corporation’s self-insurance status effective August 31, 2022.

Given the conflicting information about this employer, providers should be aware of this situation when treating Lockheed Martin's injured workers.

daisyBill will keep readers updated on the latest developments.

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