Electronic Billing in a Nutshell

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THE LAW

  • The electronic billing mandate is a statute that's in the Labor Code, as Title 8 of CCR: Sections 9792.5.1(b), 9792.5.2(c) and 9792.5.3(b).
  • In effect since October, 2012.
  • Requires insurers to accept electronic bills from providers who treat workers' comp patients.
  • Requires insurers to electronically process those electronic bills and send out electronic EORs.
  • Shortened timelines for processing and payment of electronic bills.

THE BENEFITS

  • Compared to paper bills, electronic bills are faster, more easily processed, and more easily tracked.
  • More efficient system for providers, insurers, and regulators than paper billing.
  • Lower costs of administration for everybody.
  • Results in more providers willing to treat injured workers.
  • Transparent system, with easy, instant data about how bills are being sent, paid, and processed.
  • Provides actionable data upon which to base regulatory decisions.

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