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Claims Administrator Days to Payment for 2016 Med-Legal Bills

February 22, 2017 by Catherine Montgomery

Last week on the blog, we published data on the top 20 California claims administrators who processed original electronic medical treatment bills on behalf of our clients in 2016. The takeaway? Electronic billing for California workers’ comp is really, really fast. Today, we turn our eye on a different type of workers’ comp bill – one for medical-legal services. Unlike medical treatment bills, no California regulations exist to govern – or even condone – electronic billing for medical-legal evaluation. Yet electronic billing still yields astonishingly fast payment for medical-legal bills – to say nothing of its environmental impact.

DaisyBill clients submitted almost 40,000 original electronic med-legal bills last year. We isolated the top 10 claims administrators for original electronic med-legal bills by volume to see who handled the most.

Pie Chart:

Sedgwick, State Compensation Insurance Fund, and Gallagher Bassett form our top three – these are the same three claims administrators that combined for the most original electronic medical treatment bills.

Of course, medical-legal bills are a whole other animal. Claims administrators handling electronic med-legal bills are not subject to the fifteen-day payment requirement of Labor Code 4603.4. What’s more, per Labor Code 4622, payment is due a whopping 60 days from the date of receipt of the medical-legal bill . Bearing that in mind, the average days to payment for these ten claims administrators are extraordinary.

Bar Graph:

Once again, Liberty Mutual captures the crown (and our hearts) – Liberty Mutual rated as our fastest-paying claims administrator throughout last year, and shows no sign of slowing down. Their average of 7.46 business days to payment for medical-legal bills even beats their scorching 7.72 average for medical treatment. Gallagher Bassett and State Compensation Insurance Fund also deserve commendation for their quick payment times, each clocking in at under 15 business days.

On the other end of the spectrum, York Risk Services and Tristar Risk Management bring up the rear. But even their averages – 23.32 and 24.59 business days, respectively – are much, much quicker than the 60 days claims administrators are given to process med-legal bills.

What’s more, this fast payment is consistent. Even though claims administrators are not required by law to accept electronic medical-legal bills, fewer than 2,000 of the 40,000 original electronic med-legal bills submitted by our clients required a fax follow-up. And all of these claims administrators should be praised for demonstrating environmental conscientiousness – medical-legal bills are notoriously paper-intensive, making electronic billing the best choice for the planet, as well as for payment.

Stay tuned for more analysis of the fastest and slowest claims administrators of 2016 – we’ll be back soon with a closer look at second reviews, electronic EOR compliance, and more.


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DaisyBill is a trusted authority on workers’ comp billing. Thousands of work comp professionals attend our webinars and state agencies and professional organizations turn to us for our expertise. We created this blog to help everyone involved in workers’ compensation; sharing news, tips, and data of interest to the community.

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