Insurer Liberty Mutual and its Third-Party Administrator (TPA), Helmsman Management Services LLC, need to brush up on California law regarding refunds.

More importantly, they need to refrain from attempts to harass and intimidate doctors who refuse to capitulate to legally invalid demands for refunds.

Yet again, Helmsman requested a refund from a doctor on behalf of Liberty Mutual, demanding $459.20 for an alleged “overpayment.” After the doctor (appropriately) ignored the letter, Liberty Mutual sent subsequent aggressive emails, reportedly demanding the refund 11 separate times and ultimately threatening to send the doctor to collections.

Helmsman and Liberty Mutual, lean in and listen.

Unless it’s to comply with an order from a judge, the Workers’ Compensation Appeals Board (WCAB), or a contract stipulating refunds, no California provider has to return a dime to you—even if there was a legitimate overpayment (which in this case, there wasn’t).

Providers, if you receive emails like the ones below from Liberty Mutual or any other insurer, consider them spam—they can only harm you if you engage with them.

Employers, if this is how carelessly Liberty Mutual and Helmsman treat doctors, what does it say about how they’re treating your injured employees?

Helmsman Pays for Orthopedic Surgery, Changes Mind

In April last year, an orthopedic surgeon billed Helmsman for a procedure they performed on an injured worker. Helmsman paid the bill on behalf of Liberty Mutual without objection.

But almost a month later, the orthopedist received the letter below from Helmsman, which claimed that payment for billing code CPT 23405 “should have been denied.”

Helmsman insisted the doctor owed the TPA $459.20 to rectify the “error.”

The practice did exactly what any practice should do upon receiving a letter like the one above: nothing. The practice did not issue the refund or respond to Helmsman’s request.

That should be the end of the story.

However, almost a year later, the practice received a direct communication from Liberty Mutual demanding a refund. In May 2025, Liberty Mutual sent the email below to the practice, reiterating the refund request for CPT 23405—and escalating the dispute with a direct threat.

According to an email from Liberty Mutual, the insurer hassled the provider 11 times for a refund, ultimately stating (emphasis ours):

“11th Request: if there is no response this will be moved to our collection vendor.”

Legally, the practice would be within their rights to ignore this email (along with the other 10 reported refund requests). Out of an abundance of courtesy, the practice responded to Liberty Mutual by:

• Reminding the insurer that providers have no legal obligation to issue refunds, even in the event of an overpayment, except in extremely limited circumstances
• Demonstrating Helmsman’s/Liberty Mutual’s error in concluding that CPT 23405 “should have been denied” as “inclusive.”

Undeterred, Liberty Mutual continued to insist that a refund is due.

Refund Requests/Threats: The Spam of Workers’ Comp

Understandably, threats from massive national insurers can be intimidating for providers—but these threats are empty.

A California court determined that once a claims administrator remits payment, it cannot be taken back unless the provider has a separate contract with the claims administrator that expressly requires refunds, or unless a judge or the WCAB orders it.

That ruling makes sense: claims administrators frequently cite bogus reasons for reductions and denials—and switch their reasoning when the initial reason falls flat. If claims administrators could reignite disputes post-payment, the battles would never end.

California cannot expect providers to spend time and administrative resources defending revenue they already received, in addition to the time and resources they already spend fighting for correct payment in the first place.

Providers, know your rights; in too many scenarios, claims administrators can (and do) profit from providers’ lack of information about workers’ comp payment requirements, fee schedules, and more.

Sending nearly a dozen requests and threatening collections is not acceptable; it’s harassment, plain and simple. Providers, never give in to high-pressure tactics.

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WORKERS’ COMP BILLING: SOLVED