Coming Soon: CA Med-Legal Billing Data

Coming Soon: CA Med-Legal Billing Data

There’s only one way to understand, navigate, and improve workers’ compensation: by the numbers.

Since the introduction of the new Medical-Legal Fee Schedule (MLFS) in April 2021, DaisyBill physicians have submitted over 43,000 bills for Medical-Legal services. The data from these bills offers powerful insights.

Coming Soon! DaisyBill will release comprehensive data on Medical-Legal billing for all California claims administrators. Today, we are offering a glimpse into the future.

By compiling and sharing this Medical-Legal billing data, we hope to shed much-needed light on what’s driving workers’ comp Medical-Legal costs in California, and what California can do to make the system more equitable for all stakeholders.

The MLFS data will be presented in several important ways. For example, in the preliminary screenshot below, we show the reimbursement total due by claims administrator, and sub-categorized by the type of charge, including:

  • MLFS Base: Billing codes ML200 through ML204 reimbursement due
  • Modifier Fee: Additional reimbursement due where the bill included a modifier or multiple modifiers
  • Record Review Fee: Reimbursement due where MLPRR reported
  • Diagnostics Fee: Total OMFS reimbursement due for reported diagnostic testing

The MLFS data will be further dissected according to other parameters. In the preliminary screenshot below, we crunched the specific reimbursements due for:

  • Interpreter Fees (Modifier -93)
  • AME (Modifier -94)
  • Psychiatric services (Modifier -96)
  • Toxicology (Modifier -97)
  • Oncology (Modifier -98)
  • Record Review (MLPRR)

Get ready for a deep dive into exactly where the money is spent for Medical-Legal services in California.

DaisyBill makes authorization, payment, and appeals faster, easier, better. Contact us to learn how DaisyBill can save your practice thousands in revenue for workers’ comp services.


How did you like the article ?

DaisyBill provides content as an insightful service to its readers and clients. It does not offer legal advice and cannot guarantee the accuracy or suitability of its content for a particular purpose.