Workers’ comp billing is complex. But with access to the right data and information, providers can more effectively manage revenue (and protect against claims administrator non-compliance).

That’s why daisyBill maintains a Claims Administrator Directory featuring vital information on over 700 insurers, self-insured employers, and Third-Party Administrators (TPAs).

While this essential information is available to daisyBill clients in our workers’ comp billing software, the Directory is also publicly available at no charge to the entire workers’ comp community on our website.

Below, see a brief video outlining the information and data the Directory provides.

The Power of Data

The Claims Administrator Directory features aggregated billing data from our clients across hundreds of claims administrators. The information and data presented are based on millions of bills delivered to these claims administrators annually by nearly 6,000 providers.

Most importantly, the Claims Admin Directory is always current; we update it daily to reflect a rolling 365-day data collection period.

Zooming in on the list of claims administrators, the Directory homepage (shown below) features quick facts and data for each workers’ comp insurer, self-insured employer, and TPA. For the previous 365 days, the data includes:

• Provider Count - Number of providers who billed the claims administrator
• Injury Count - Number of injuries addressed
• Bill Count - Number of bills sent to the claims administrator
• Bill Delivery - How daisyBill sends bills to the claims administrator
• Duplicate Bill % - The percentage of bills providers needed to resubmit as duplicates
• Avg Days To Pay - The average number of business days it takes the claims administrator to pay a provider’s bill

Visitors can search for specific claims administrators or reorder the list based on the information in each column. Clicking View will access more data and information about each claims administrator. 

For example, as shown below, clicking View for TPA Sedgwick directs visitors to details including:

• Contact Information, including hours of operation
• Bill Review entities
• Web Portals for checking bill status
• CA Medical Provider Networks (Caveat: This MPN information comes directly from the Division of Workers’ Compensation’s List of Approved MPNs, which is often inaccurate, outdated, and generally useless; however, it is the only MPN information the DWC makes available to the public.)

Diving even deeper, Sedgwick’s dedicated page outlines the TPA’s compliance rate with several state requirements—so providers know exactly what to expect.

Moreover, state legislators, regulators, and the general public can review data to determine whether claims administrators comply with state laws and regulations.

For example, the data demonstrates that Sedgwick only complies with California’s requirement to send providers electronic Explanations of Review (X12 835 EOR) for 70% of e-bills providers send. (Pro tip: rather than waiting for daisyBill to send hundreds of thousands of Audit Complaints, the CA DWC could simply take a peek at Sedgwick’s Directory page).

The more providers (and legislators and regulators) know about claims administrators—from how to reach their bill review service, to whether or not they accept e-bills, to how likely they are to break payment laws and regulations—the better.

Compiling and sharing data in the Claims Administrator Directory is how daisyBill helps workers’ comp function more effectively. Clients and non-clients alike are invited to use the Directory and reach out with any questions; simply use the chat feature in the bottom right corner of this page or email us at info@daisybill.com.

We want to hear from you, and we’re happy to help.

The video above was replaced with an updated version on August 22, 2024.

Nationwide, daisyBill increases revenue and decreases hassle for providers who treat injured workers. Get a free demonstration below.

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