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Provider Alert: Broadspire Contorts Work First Casualty Claims

Provider Alert: Broadspire Contorts Work First Casualty Claims

Broadspire is the designated third-party administrator (TPA) for Work First Casualty Company, a workers’ comp insurer. While Broadspire normally conducts its own internal bill review for claims Broadspire administers, for bills payable by Work First Casualty, Broadspire uses EK Health as the bill review vendor.

Why the alert? Because when sending bills for employers insured by Work First Casualty, Broadspire instructs providers to send bills to a different mailing address and to use a different EDI clearinghouse and payer ID when transmitting bills electronically.

In order for a provider to properly route a bill to Broadspire, the provider must always ask the Broadspire adjuster where to send bills for the injured worker. The answer should be one of the following: 

1. To Broadspire or

2. To EK Health

In order to receive payment, Broadspire forces providers to spend resources to determine an employer’s underlying workers’ comp insurance. This forced contortion is exactly the reason providers will not treat injured workers. It is just too damn difficult to get paid.

Complex Payer/Clearinghouse/Bill Review Relationships

For workers’ comp bills, Broadspire confusingly maintains two separate designated electronic billing clearinghouse vendors and two mailing addresses.

For electronic bills, effective June 7, 2021, Broadspire changed its clearinghouse from Availity to Carisk. To send bills electronically, Broadspire instructs providers to use Carisk Payer ID E8088. For non-electronic bills, Broadspire instructs providers to mail bills to the following address:

PO Box 14645
Lexington, KY 40512

The above is true EXCEPT EXCEPT EXCEPT when the injured worker’s employer workers’ comp insurance is furnished by Work First Casualty. Under these circumstances, Broadspire instructs providers to send bills for Work First Casualty claims to a different bill review vendor and clearinghouse. 

For electronic bills, providers must use the clearinghouse WorkCompEDI and Payer ID LV119. For non-electronic billing, Broadspire instructs providers to mail bills to the following address:

WFC Billing c/o EK Health
2351 Sunset Blvd, Suite 170-893
Rocklin, CA 95765

If a provider fails to adhere to the Broadspire convoluted and contorted billing instructions, then the provider’s bills will not be processed. For e-bills, Broadspire will reject the electronic transmission of a bill when the employer's underlying insurer is Work First Casualty and the bill is sent using Payer ID E8088.

Broadspire Billing Contortions

DaisyBillers, rest easy. We have this complexity solved for you!

In DaisyBill, we established a separate “Payer” (so to speak) under Broadspire to accommodate this contorted billing arrangement. For all bills for which Work First Casualty is the chosen payer, DaisyBill will correctly route these bills to WCEDI to deliver to EK Health.

Unfortunately, even DaisyBill providers must still ask Broadspire adjusters where to send bills for the injured worker, either Broadspire or EK Health.

In our opinion, the California Division of Workers’ Compensation should prohibit Broadspire from establishing multiple bill addresses (for e-bills and mail). Multiple addresses for workers’ comp bills is simply more friction, burdening providers’ staff who are simply trying to receive payment for treating injured workers.

DaisyBill doesn’t miss a beat. Changes to TPAs, clearinghouses, and bill review services are just one part of what we navigate on providers’ behalf. To make authorization, billing, and appeals easier and faster, contact us today.


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