California workers’ comp is losing doctors. The underlying issues are manifold, from payer non-compliance to network discount schemes to Medical Provider Network (MPN) chaos.

But recently, The Hartford provided an example of the plain old bureaucratic abuse that could tempt any provider to give up on treating injured workers.

Fortunately, the provider is a daisyCollect client, which means that our representatives endured the rigors of this payment odyssey on the provider’s behalf. However, the sheer absurdity of the process tested the mettle of even our most seasoned daisyCollect veterans.

The Hartford Shorts Provider

Claims administrators erroneously underpay providers all the time. This case was strange because The Hartford’s Explanation of Review (EOR) reflected the correct reimbursement, but the actual check amount was less than the amount listed on the EOR.

As the EOR (below) shows, Hartford agreed to pay $650.00, the amount the provider billed and due per the Medical-Legal Fee Schedule.

Yet mysteriously, the check included with the EOR was for only $488.50. As shown below, the EOR did not reference the payment reduction or explain why the check amount did not match the EOR Allowance.

The Hartford Gives daisyCollect Extended Runaround

Naturally, daisyCollect reached out to The Hartford about the check discrepancy. To spare readers the pain of experiencing the ensuing goose chase in full narrative form, we present the ensuing payment drama in steps:

Step 1. On 4/17/2024, daisyCollect called The Hartford, whose representative stated that the reduction was “due to a federal or state tax” and advised calling The Hartford’s Finance Department. The representative provided a phone number to said department.

Step 2. daisyCollect called the Finance Department, which rang to the voicemail for the Accounting Controls Department. The voicemail recording provided an email address and advised emailing Hartford’s Finance Department.

Step 3. As instructed by the voicemail, daisyCollect emailed The Hartford Finance Department as shown below.

Step 4. The next day, on 4/18/2024 daisyCollect called The Hartford to obtain contact information for the adjuster assigned to the claim.

Step 5. daisyCollect called the adjuster, who apologized but could not explain the payment discrepancy, and acknowledged that the full $650 payment should have been remitted. The adjuster advised speaking with the Finance Department.

Step 6. On 4/22/2024, daisyCollect sent a second email to The Hartford’s Finance Department.

That same day, the Finance Department forwarded daisyCollect’s email to the adjuster with instructions to "Please see the email below.” Yes, that’s the same adjuster who advised daisyCollect to speak to the Finance Department.

Fortuitously, the Finance Department email included Walt Disney's apt quote: “The difference between winning and losing is most often not quitting” (sigh).

Step 7. On 4/23/2024, The Hartford Tax Services and Reporting Unit emailed daisyCollect, stating, “The reason there is backup withholding is because we do not have a W9 on file. Please fill out the attached W9 and respond to this email."

Except…daisyCollect included the W-9 among the documents submitted with the original bill, as shown in the screenshot below; daisyCollect always includes W-9s with every bill sent.

Step 8. daisyCollect submitted the already-submitted W-9.

Step 9. The daisyCollect agent closed their eyes, took several deep, measured breaths, and reflected on how real human beings (i.e., injured workers) and their actual health are subject to the bureaucratic ineptitude of insurance companies every day.

Step 10. daisyCollect waits for The Hartford to issue the correct reimbursement.

To review this reimbursement goose chase, The Hartford:

• Sent a provider a false EOR indicating a reimbursement amount different from the check amount.
• Withheld money from a provider by incorrectly claiming it lacked a W-9 for the provider.
• Inflicted payment abuse seemingly designed to test Walt Disney’s maxim on not giving up.

Providers endure odysseys like this to receive payment far too often. Is it any wonder they’re doing the math, checking their mental health, and concluding that workers’ compensation simply isn’t worth it?

Workers’ comp billing requires specialized expertise. daisyCollect agents use our advanced software (and unmatched experience) to protect your practice’s bottom line. Schedule a call below:

SCHEDULE CALL