ML200 - Liberty Mutual Insurance: Grade F
Claims administrator failed to properly reimburse ML200. Liberty Mutual incorrectly denied valid medical-legal code as exceeding fee schedule allowance. Date of Service: 04/05/2021
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 |
Liberty Mutual Insurance |
Bill Review Vendor |
Liberty Mutual Insurance |
Employer |
Primer Food Concepts LLC / Luna |
|
EOR Adjustment Reason |
G1 - The charge exceeds the official medical fee schedule allowance. The charge has been adjusted to the scheduled allowance. |
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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