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ML200 - AmTrust North America: Grade F

ML200 - AmTrust North America: Grade F

Claims administrator failed to properly reimburse ML200. AmTrust incorrectly re-coded ML200 to ML100. Date of Service: 04/02/2021

MLFS Code(s)

ML200 - Missed Appointment for a Comprehensive or Follow-Up Medical-Legal Evaluation

MLFS Modifier(s)

95 - Evaluation performed by a panel selected Qualified Medical Evaluator

MLFS Grade


Claims Administrator

AmTrust North America

Bill Review Vendor

Mitchell International


Industry Rag, LLC


Adjustment Reason

G5 - This charge was adjusted for the reasons set forth in the attached letter.

Second Review Reason to dispute incorrect reimbursement

Claims administrator incorrectly denied reimbursement. Per CCR §9795, ML200 has a Relative Value of 31 and missed appointments are reimbursable when the interpreter fails to appear for the evaluation appointment. ML200-95 payment due: $503.75. In addition to payment, penalties and interest are now due.

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