There’s a shamelessness to the ways some payers and vendors try to increase profits by slashing California doctors’ reimbursements for treating injured workers.

Claims administrators make Medical Provider Network membership conditional on Preferred Provider Organization discounts. Network middlepeople intercept reimbursements and keep a cut. Grifters send unsolicited checks that are discount contracts in disguise. Seemingly random entities send threats of “intervention,” avoidable for a price.

Add to the list: StrataCare’s “offer” to a California orthopedic practice to pay just 72% of the workers’ comp fee schedule rates in exchange for…nothing.

In response to a bill the practice sent to insurer The Hartford, StrataCare offered the practice $1,725.00 for treatment that costs $2,395.81 under the Physician Fee Schedule. The only vague semblance of an incentive: “priority processing” and a promise (which StrataCare retracts in the fine print) that “payment will be issued within 7-10 business days.”

Bear in mind that California legally requires payment of this bill in 15 business days (and daisyBill providers are typically paid much faster). See StrataCare’s painful pitch below, and when your practice receives something like it, take the only reasonable action: ignore it.

StrataCare Lowballs Provider

Earlier last month, the orthopedic practice sent a bill for shoulder surgery to The Hartford. A few days later, the practice received a “TIME SENSITIVE” email from StrataCare (part of MedRisk, a company steeped in the art of extracting profits from provider reimbursements) with the offer below attached.

StrataCare’s “Urgent” proposal, like many dubious discount offers, cringingly attempts to manufacture a sense of FOMO, insisting that “The agreement is null and void if not signed, dated and returned within 4 days…”

The letter even specifies an exact time (11:00 AM PST) at which the offer expires, as if StrataCare would ever say “no” to a provider willing to give away their reimbursements, regardless of any artificial deadlines.

StrataCare offered 72% of the fee schedule rate for the surgery and implied that accepting the discount will somehow speed up payment, claiming that if the provider accepts, payment will arrive within 7-10 business days.

Except, the fine print clarifies that “...your acceptance will not guarantee payment earlier than as required under applicable laws and regulations.” 

In this case, California mandates payment within 15 business days for all bills that providers submit electronically. Moreover, daisyBill providers receive payment in 9.4 days on average at the time of this writing, based on the last 365 days of data from our systems.

So, at best (but not “guaranteed”), this provider would give away 28% of their revenue to (possibly, but maybe not) get paid 5-8 days sooner than the law requires, and likely no sooner than the average daisyBill provider receives payment.

Adding one last dubious, flimsy implication of faster payment, the letter exhorts the provider to respond quickly for “priority processing,” whatever that means (our bet: nothing).

Offers like this are a fact of life for providers who treat injured workers. They must succeed at least some of the time, because we see example after example, even for Medical-Legal services that are not subject to the same discount mechanisms as medical treatment bills.

In other words, even spam sometimes produces the desired result.

Don’t be one of the providers who give companies like StrataCare, its corporate boss MedRisk, or MedRisk’s private equity bankrollers a reason to keep issuing these garbage offers. Treat them as you would any other piece of junk (e)mail, and insist on full fee schedule reimbursement.

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