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In Case You Missed It: San Mateo and Sonoma Counties Change TPAs

August 14, 2017 by Catherine Montgomery

Two California counties recently transferred their claims from Northern Claims Management to new administrators. Not surprisingly, communication about these changes was minimal—  and providers may find themselves improperly reimbursed as a result.[a][b]

Effective July 1st, San Mateo County transferred all claims to Athens Administrators, while Sonoma County transferred all claims to Intercare Holdings Insurance, Inc. In both cases, all claims numbers will remain the same and are searchable in the current TPAs’ respective systems.

By way of keeping providers up to date, Northern updated its automatic voice messaging. Northern rerouted calls to their main line (707-575-8887) to pre-recorded announcements about the changes, and included the current TPA’s phone number and mailing address.

However, those wishing to speak with representatives at Northern will meet with little success. Pressing ‘0’ for the Operator leads to a voicemail box. Northern replaced the direct line to their Claims Assistant (707-547‑3701) with a recording announcing San Mateo County’s switch to Athens.

According to representatives at both Athens and Intercare, letters informing providers and claimants of the change were sent out, though Intercare could not confirm the recipients.

DaisyBill has moved quickly to update billing routes for our providers. We’ve established an electronic route with Athens, and will be faxing bills to Intercare’s Roseville office until their representatives can provide electronic routing information.

Any providers in the affected counties who were improperly reimbursed for claims originally submitted to Northern Claims Management should submit appeals to the current TPA.

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We update DaisyBill's Billing Software constantly to align with new developments in workers’ comp billing. To ensure correct reimbursements regardless of changes in codes, fee schedules, or administration, contact us.

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[a]This is the first paragraph

[b]I changed "have transferred" to "recently transferred." Compound tenses also loathed around here.

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