Late bills will not be paid. Period.
Timely billing has been in effect in California workers’ compensation since January 1, 2017, but we still see providers missing this all-important deadline. The passing of Senate Bill 1175 introduced a billing deadline for all medical and medical-legal services of one year from date of service (DOS).
The California Division of Workers’ Compensation established that timely submissions are incumbent on providers. Our advice on timely bill submissions is simple: Send it on time or give up on payment.
First, here’s a quick reminder of the timeframes for submitting original bills.
Action |
Deadline |
Untimely Penalty |
Statute |
Submit Original Bill for Medical Services |
Within 12 months of DOS |
Payment not due |
LC §4603 |
Submit Original Bill for Medical-Legal Evaluation and Related Medical-Legal Services |
Within 12 months of DOS |
Payment not due |
LC §4625 |
Plain and simple: Remit your bill within 12 months of DOS or forever hold your peace -- payers are not required to process late bills. Remember that the Workers’ Compensation Appeals Board now retains very little jurisdiction over medical billing disputes. A lot of battles will be fought in Independent Bill Review or before the AD, rendering liens more of an exception reserved for those rare scenarios where something goes terribly wrong.
Although the regulations leave the door open for circumstances under which a late bill could be paid, the Administrative Director, George Parisotto, has yet to enumerate the circumstances. Until that happens, get your bills in on time.
DaisyBill renders medical billing a cinch with electronic billing solutions and streamlined appeals processing. One of the many benefits of electronic transmission is that every bill receives an electronic proof of receipt from the payer so providers can easily PROVE timely filing.
Our cloud-based software gives you as much peace of mind as is possible in workers’ comp. Sign up for a free demo today and see what DaisyBill can do for you.
DaisyBill provides content as an insightful service to its readers and clients. It does not offer legal advice and cannot guarantee the accuracy or suitability of its content for a particular purpose.