A simple fact about workers’ comp: electronic billing (e-billing) makes billing and payment faster and smoother for providers and payers, to the benefit of employers and injured workers nationwide.

…but it only works if both sides of the billing transaction do their part.

That’s why daisyBill brings a new layer of accountability to the system by publicly sharing Electronic Data Interchange (EDI) data. Based on how effectively they handle providers’ e-bills, we assign every insurer, self-insured employer, and Third-Party Administrator (TPA) in our system an ‘EDI Grade’ from A+ to F.

Today, we highlight some of the best performers in our Claims Administrator & Network Directory, the payers (aka claims administrators) that prove beyond a doubt that statistically flawless e-billing is possible.

Below, we also take a closer look at the following standouts:

• California’s State Compensation Insurance Fund (CA State Fund)
• The US Department of Labor (DOL)
• Walmart

See all the A+ superstars below, and join us in posing an important question about payers with lower EDI Grades: what’s their excuse?

daisyData: The Best Payers in the Game

The screenshot below from our Claims Administrator & Network Directory shows all of the payers in our system that earned an A+ over the last 365 days, in order of the volume of bills they receive from our providers.

Kudos to all 17 insurers, employers, and TPAs below for making workers’ comp work better for everyone.

As explained in our introductory article, we track EDI performance on a rolling 365-day basis. Among these A+ admins are payers that cover large numbers of workers and field a substantial volume of e-bills, including in multiple states.

Below, we take a closer look at a few standouts, each demonstrating that there is no valid reason not to accept and correctly process providers’ e-bills.

A+ Insurer: CA State Fund

The CA State Fund is a non-profit insurer covering tens of thousands of employers across the Golden State. As measured by the volume of bills it processes for our providers, CA State Fund is also the third-largest payer in our entire system.

As the EDI stats show, CA State Fund is impeccable in accepting and responding to providers’ e-bills, earning a 98% overall grade.

A+ Public Self-Insured Employer (Federal): DOL

The US DOL self-insures to cover injured federal workers nationwide. It is also one of the rare payers that accepts and processes its own e-bills without relying on a clearinghouse, as almost all other payers do.

Since we first started submitting e-bills to the DOL, we’ve been impressed by the agency’s consistently excellent EDI performance.

A+ Private Employer: Walmart

Walmart is a behemoth private employer with over 1.5 million employees nationwide. Walmart self-administers many of those employees’ injury claims, depending on the state.

Handling bills for that volume of workers is undoubtedly a huge lift, yet Walmart doesn’t break a sweat when it comes to running a smooth EDI operation. Our data indicate that when a doctor treats a Walmart employee, the billing and payment process will likely be smooth sailing.

We commend every one of our A+ payers, large and small, for demonstrating that accepting and processing e-bills properly is a matter of choice. If the CA State Fund, the federal DOL, and Walmart can make it work, there’s no reason our lesser-performing payers can’t get their act together.

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