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 |
F |
Claims Administrator |
AmTrust North America |
Bill Review Vendor |
Mitchell International |
Employer |
Industry Rag, LLC |
|
EOR 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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