Wonder why doctors are fleeing workers’ comp, and why injured Marriott employees might soon have no one left who’s willing to treat them?

Start with a single $145 bill, and follow it through a bureaucratic labyrinth of multiple Marriott vendors, each more inept than the last.

Marriott is a self-insured, self-administering employer. To manage claims for its injured employees, Marriott employs a host of bill review and payment vendors. As demonstrated below, these vendors can be ill-informed, lack coordination among themselves, and have collectively created reimbursement havoc for at least one doctor treating Marriott employees.

Recently, we shared how Marriott’s bill review vendor, Genex, misinforms providers by claiming that Marriott does not accept electronic bills (e-bills), in violation of several states’ laws. However, that was only one leg of a mind-bending journey through the payment Upside Down Marriott and its vendors have implemented.

Haphazard, inept, and non-compliant claims management, as in this Marriott example, is the reason doctors often refuse to treat injured workers. It’s simply too damn hard to get paid for treatment.

With doctors fleeing, employers’ costs rise as injured workers struggle to find care (and turn to attorneys for help). Meanwhile, vendors like Genex, Advanet/Paradigm, and ECHO cash in as providers tap out.

Despite what you may have heard about apples, the nightmare below is what actually keeps the doctor away (from workers’ comp).

Marriott Bill Review Pays Advanet Instead of Doctor

On August 22, 2025, a doctor sent Marriott an e-bill for the treatment of one of its workers. Under California law, Marriott is required to pay the doctor within 15 working days of receipt of the e-bill. In this case, the payment deadline was September 15, 2025.

On September 8th, Marriott’s bill review vendor, Genex, responded to the doctor’s e-bill by sending the doctor an electronic Explanation of Review (e-EOR) indicating that Genex paid Advanet $145.27 on September 3, 2025.

Rather than paying the doctor, the Genex e-EOR listed Advanet as the “Payee” along with Advanet’s address. Since the e-EOR listed Advanet (not the doctor) as the payee, daisyBill software designated the e-EOR as invalid and did not post the payment to the e-bill.  

Important Provider Alert: If you've treated a Marriott employee, you may want to confirm whether your billing technology invalidates e-EORs that have incorrect payee information. Without this automation, an e-EOR listing Advanet as the payee could post to the bill, but your funds remain in Advanet's bank account.

Duplicate Bill Denied…for Being a Duplicate Bill

With no valid e-EOR indicating that the doctor received payment, our software automatically submitted a duplicate e-bill to Marriott on October 21, 2025.

On November 11, 2025, Genex responded with a second e-EOR denying payment on the grounds that the e-bill was a duplicate. Notably, the new e-EOR listed the doctor as the “Payee” and listed the doctor’s correct “pay-to” address.

On December 3, 2025, daisyBill contacted Marriott to investigate the non-payment. The Marriott representative informed our agent that Marriott had not paid the doctor’s bill, but instead forwarded it to Advanet for processing.

More Marriott Vendors: Just as Inept

daisyBill contacted Advanet, whose representative claimed that they processed the bill on September 19, 2025 (four days after the legal payment deadline) and instructed daisyBill to access the payment EOR through the ECHO portal (ECHO provides payment processing services and maintains payment records for several companies).

Inside the portal, our agent discovered an “Explanation of Payment” indicating that Paradigm had discounted the doctor's payment to $131.71 and had sent the payment to the wrong address.

On December 4, 2025, daisyBill contacted Genex to determine why Paradigm was sending the doctor’s payments to the wrong address.

After erroneously claiming that the bill was not on file, the Genex representative confirmed that Genex had forwarded the bill listing the doctor’s correct pay-to address (along with all documentation, including the W-9 listing the correct pay-to address), to Advanet.

Paradigm Makes Ludicrous Demand

Next, daisyBill contacted Paradigm. The call was 23 minutes of administrative absurdity, courtesy of a company whose primary function appears to be little more than siphoning employer dollars from providers in exchange for…well, we’re not sure.

A Paradigm representative confirmed that their systems listed the wrong address for the doctor.

When daisyBill pointed out that the doctor’s bill and W-9 listed the doctor’s correct pay-to address, Paradigm made a stunning assertion: the provider should have sent Paradigm an updated W-9. On December 8, 2025, a Paradigm “Senior Provider Networks Contact Center Agent” left a voicemail and sent an email to daisyBill, both of which confirmed that Paradigm required the doctor to submit a recent W-9 directly to Paradigm.

In other words, to receive payment for treating a Marriott employee, Paradigm claims that the doctor is responsible for sending an updated W-9 to Paradigm, an entity that is neither a bill review service nor a claims administrator, and has no direct relationship with the doctor.

Let’s review the facts:

1. The doctor submitted a bill to Marriott with the correct pay-to address and a W-9 verifying that address.
2. Marriott’s bill review, Genex, did not pay the doctor; it paid Advanet and denied payment when the unpaid bill was resubmitted.
3. Genex instructed that the doctor must access a separate ECHO portal to confirm payment.
4. The ECHO portal shows Paradigm sent the doctor’s payment to the wrong address, even though the correct address was listed on the bill and the doctor included a W-9 with the correct address.

On December 8, 2025, daisyBill updated the ECHO portal and sent Paradigm a W-9, as (absurdly) requested.

…but if you think that was the end of the payment nightmare, think again. In Part 3 of this series, we’ll show how Paradigm mailed payment to the wrong address, even after receiving the updated W-9 twice.

This is payment incompetence on a never-ending loop. If this is how Marriott treats the doctors trying to heal their employees, what hope does an injured worker have?

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