City of Glendale Should Treat Providers Better
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California providers, take note: the City of Glendale is making it impossible for providers to submit valid electronic bills for the treatment of injured workers.
This follows a shift in how Glendale, a self-insured public employer, processes workers’ comp e-bills.
Previously, Glendale administered some of their claims with the help of an outside bill review service, and Third-Party Administrator (TPA) Adminsure handled the claims for Glendale’s fire, police, and retired municipal employees. Effective June 1, 2023, Adminsure took over administration duties for all Glendale claims.
However, Adminsure confirms that the TPA does not have the claims data necessary to process the e-bills for which Adminsure is newly responsible as of June 1. As a result, providers have no choice but to fax those bills directly to Glendale (daisyBillers, rest easy: we’ll make sure our clients’ bills get to the right place).
Payer non-compliance necessitating extra work for practices? It’s just another day in California workers’ comp, where daisyBill sends even more Audit Complaints into the deep, dark hole known as the Division of Workers’ Compensation (DWC).
City of Glendale Drops e-Billing Ball
Beginning on July 28, 2023, the clearinghouse employed by Glendale began rejecting provider e-bills.
daisyBill immediately contacted Glendale, and learned that Adminsure had taken over claims administration and bill review duties for all bills as of June 1. Despite this change, Glendale instructed daisyBill to continue sending e-bills to Glendale rather than Adminsure.
daisyBIll contacted Glendale’s clearinghouse, which reported to daisyBill that the Payer ID number used for City of Glendale is a “paper-only” route — meaning that instead of electronically forwarding e-bills to Glendale for processing, the clearinghouse simply faxes these bills to Glendale.
daisyBill then contacted an Adminsure adjuster responsible for Glendale claims. The Adminsure adjuster reported to daisyBill that there was no access to Glendale claim data despite Adminsure taking over on June 1. Further, the adjuster does not expect the claim data for several weeks.
Failure to abide by California’s legal requirement to accept, process, and respond electronically to e-bills robs practices of time and resources. We urge the City of Glendale and Adminsure to get their ducks in a row immediately, and treat compliance as a duty — not a favor to providers.
Below is a log of the action daisyBill took on behalf of our providers, in order to navigate this abject failure by Glendale to comply with California e-billing laws and regulations:
Date |
Action |
7/28/2023 |
City of Glendale started rejecting e-bills. |
7/31/2023 |
daisyBill called City of Glendale. Per City of Glendale claims representative, effective 6/1/2023, all claims are administered by Adminsure.
However, bills should continue to be sent to City of Glendale directly, as Adminsure does not have claim or bill data yet.
When asked for an anticipated resolution date, City of Glendale was unable to provide additional information. |
7/31/2023 |
daisyBill called Adminsure. Adminsure claims representative was unable to locate the claim in question and forwarded daisyBill to Adminsure bill review. |
7/31/2023 |
daisyBill spoke with Adminsure bill review representative, who was also unable to locate the claim in question and provided daisyBill with contact information for the two adjusters handling City of Glendale claims. |
7/31/2023 |
daisyBill left a voicemail for one Adminsure adjuster, and spoke with the other. Adminsure adjuster was unable to locate the claim in question. Adminsure adjuster was aware of the 6/1/2023 effective date for Adminsure handling all City of Glendale claims and (flippantly) reported that the data would be available the following week.
When questioned about data regarding an injury from January 2023, Adminsure adjuster said, “Yeah, you're going to have to at least give at least two to three weeks before we can advise you on this. You're going to have to give it time.” |
7/31/2023 |
daisyBill reported rejections to Data Dimensions, the designated clearinghouse for City of Glendale. |
7/31/2023 |
Data Dimensions replied to daisyBill: “The reason for the change is the payer is no longer with the bill review that held that connection. This ID changed to a paper-only option on 7/26/2023.
There isn't another electronic option for this ID unfortunately. We're attempting to see who we can route these through to establish another connection moving forward but until that happens these can only be submitted by paper.” |
8/1/2023 |
Data Dimensions provided an update to daisyBill: “We were able to learn from the payer that they have switched to a new Bill Review [Adminsure] in which they are implementing the setup. In the meantime, we can fax your e-bills, that's how they're [City of Glendale] doing these from what their rep told us.” |
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