Bill review vendor Genex continues to share incorrect billing information with providers treating the injured employees of hotel chain Marriott.

Repeatedly, Genex representatives have instructed providers to submit electronic bills (e-bills) to an incorrect Payer ID number. Even more baffling, Genex has repeatedly claimed that Marriott doesn’t accept e-bills, which is patently untrue and would violate multiple states’ billing and payment laws.

daisyNews has reported on Genex’s misinformation problem multiple times, apparently to no avail.

daisyBill’s Claims Administrator Directory, which maintains Electronic Data Interchange (EDI) performance data on every payer in our system, currently gives Marriott an EDI “grade” of F. This directly reflects the abysmal performance of its payment and compliance infrastructure.

This is an important warning: All providers treating Marriott injured workers should expect potentially headache-inducing billing issues.

Moreover, Marriott employees should be alarmed about how difficult their employer makes it for doctors to treat them. As a self-insured, self-administering employer, Marriott controls its decision to use Genex and tolerate these repeated errors.

Genex’s Persistent Errors

Recently, Marriott failed to respond to Colorado and New York e-bills that daisyBill provider clients sent for Marriott injured workers.

The providers submitted the e-bills, and daisyBill routed those e-bills to the correct clearinghouse for Marriott, Data Dimensions, using the correct Payer ID, WZ787. After months passed with no payment, our clients contacted daisyBill, and our Compliance Team contacted Genex to investigate.

On separate calls, different Genex representatives incorrectly asserted that the e-bills were “not on file” because daisyBill sent the e-bills to the incorrect Payer ID. Genex representatives instructed that Marriott e-bills should be sent to a non-existent Payer ID, WZ2787. This is the same error Genex made in June in a previous incident.

As shown below, searching Data Dimensions for Payer ID WZ2787 results in “No matching records found.” Any provider following Genex’s instructions would presumably send their e-bill into the digital void.

Genex has repeatedly misled providers seeking payment for treating Marriott’s injured employees, creating revenue-management backlogs and potentially causing providers to miss state deadlines to take further action.

Clearinghouse + Payer ID: The Keys to e-Billing

To successfully submit an e-bill, a provider or their e-billing agent needs to know:

1. The clearinghouse through which the payer accepts e-bills (except for the rare payers that accept e-bills directly rather than using a clearinghouse, i.e. CorVel and the US Department of Labor), and
2. The specific Payer ID number that the clearinghouse assigns to the payer

daisyBill maintains an up-to-date list of correct Payer IDs that we use to route e-bills through our proprietary network of direct e-billing connections to each clearinghouse. Non-daisyBill providers may not have this advantage, leaving them at the mercy of Genex and its inexplicable bad information.

As a self-insured, self-administering employer, Marriott must ensure it responds appropriately to providers’ bills in every state. For example, Colorado’s Rule 16 states (emphases ours):

“Use of agents, including but not limited to preferred provider organization (PPO) networks, bill review companies, third-party administrators (TPAs), and case management companies shall not relieve the insurer or self-insured employer from their legal responsibilities for compliance with these Rules.”

Marriott EDI Grade: F

Once again, Marriott has demonstrated its ineptitude in claims administration, as reflected by its EDI Grade of F.

The hotel chain should question its bill review vendor and insist on a basic degree of competence in workers’ comp payment. Or perhaps the pattern and Marriott’s EDI grade suggest that the hotel chain simply does not prioritize its obligation to ensure that providers are paid for treating its injured workers.  

We cannot know the specific underlying reasons for Marriott’s failures; we know only that treating Marriott employees is fraught for providers, and that cannot bode well for the hotel chain’s employees.

daisyBill is connected directly to each clearinghouse, so your e-bills get delivered (and paid) quickly and smoothly. Click below to learn more:

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