Support Essential Workers: Suspend Workers' Comp Reporting Requirements

Support Essential Workers: Suspend Workers' Comp Reporting Requirements

While the rest of us come together by staying apart, not all Californians have the option of social distancing. Essential workers accept the high risk of exposure to COVID-19 in order to keep our state functioning at its most basic levels, knowingly subjecting themselves to danger on everyone’s behalf.

The least we owe these employees is prompt and thorough medical care when they need it.

For their part, California’s Division of Workers’ Compensation (DWC) can help by reducing the burden on logistically strained workers’ comp providers. With a few specific, temporary changes, the DWC can reduce friction, lower barriers, and otherwise clear the way for providers to serve those who are serving us in a time of crisis.

If there was ever a time to rally around essential workers, this is it. DaisyBill would like to make the following request of the DWC publicly: temporarily set aside reporting requirements.

The Burden of Unnecessary Workers’ Comp Documentation

In section 3.0 (b), the California Medical Billing and Payment Guide mandates that providers include the following with all original bills for workers’ comp treatment:

“All required reports and supporting documentation sufficient to support the level of service or code that has been billed...”

This requirement, unlike the Californians still reporting to work each day, is non-essential.

Such reporting requirements are a unique regulatory burden to which California subjects only those who treat injured workers. Neither group health insurance nor Medicare requires this level of reporting for reimbursement purposes.

For the time being, neither should workers’ comp claims administrators.

Until normal staffing can resume, the DWC should afford those providers who treat injured workers the flexibility to prioritize treatment over excessive documentation. Claims administrators should be instructed not to withhold reimbursement for services rendered to ill or injured workers for failure to meet reporting requirements.

The DWC can stand with essential employees by standing with providers.

Managing the workflows required to produce and submit these reports is a luxury the system cannot currently afford. In fact, the alleged necessity of these out-dated reporting requirements is worth examining post-coronavirus. Given the reduced administrative staff and resources that providers are currently navigating, the DWC can easily set aside this rule during the pandemic.

For all treatment including, but not limited to, telehealth services, payers should not withhold reimbursement for services and treatment provided to ill or injured workers when a provider fails to meet the current report and supporting documentation requirements.

We encourage providers to email us at info@daisybill.com with their most pressing questions and concerns, which we’ll continue to address on this blog.

To learn about why E-billing is critical during COVID-19 and the details of how workers' comp E-billing is different from group health or Medicare, sign-up for our free upcoming webinar below.


For more on telehealth rules for Medicare, California health insurers, and California workers’ compensation, look through the free resources available on our COVID-10 page.

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