ML203 - AIG Claims, Inc.: Grade F

ML203 - AIG Claims, Inc.: Grade F

Claims administrator failed to properly reimburse ML203. AIG incorrectly denied valid medical-legal code as not in the fee schedule. Date of Service: 04/01/2021

MLFS Code(s)

ML203 - Fees for Supplemental Medical-Legal Evaluations

MLFS Grade

F

Claims Administrator

AIG Claims, Inc.

Bill Review Vendor

AIG Claims, Inc.

Employer

Entertainment Partners

EOR

Adjustment Reason

2 - This charge will be re-evaluated upon receipt of the proper procedure codes or procedure code/modifier combination as listed in the fee schedule.

Second Review Reason to dispute incorrect reimbursement

Claims administrator incorrectly denied reimbursement. Per CCR §9795, ML203 is valid reimbursable procedure code that includes services for writing a report after receiving a request for a supplemental report from a party to the action or receiving records that were not available at the time of the initial or follow-up comprehensive medical-legal evaluation. Provider conducted a Supplemental Medical-Legal Evaluation at the request of the parties. ML203 payment due: $650.00. In addition to payment, penalties and interest are now due.


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