Most Recent Articles
Apr 1, 2021
ML201 - Broadspire: Grade B
Claims administrator properly processed reimbursement for ML201. The lower grade reflects that the explanation of review (EOR) incorrectly lists 99199 as the ‘Rev./Proc. Code...
Apr 1, 2021
ML201 - State Compensation Insurance Fund (CA): Grade A
Claims administrator properly processed reimbursement for ML201. Date of Service: 04/08/2021
Apr 1, 2021
ML203 / MLPRR - Beta Healthcare Group Risk Management Authority: Grade F
Claims administrator failed to properly reimburse MLPRR. Beta Healthcare Group incorrectly reduced reimbursement for record review citing “charge exceeds the official medical...
Apr 1, 2021
ML201 - Farmers Insurance: Grade F
Claims administrator failed to properly reimburse ML201. Farmers incorrectly re-coded ML201 to ML103. Date of Service: 04/05/2021
Apr 1, 2021
ML201 - AmTrust North America: Grade F
Claims administrator failed to properly reimburse ML201. AmTrust incorrectly re-coded ML201 to ML102. Date of Service: 04/13/2021
Apr 1, 2021
ML203 / MLPRR - Helmsman Management Services: Grade F
Claims administrator failed to properly reimburse ML203 and MLPRR. Helmsman Management Services incorrectly denied valid medical-legal code as not reimbursable. Date of Servi...
Apr 1, 2021
ML203 - State Compensation Insurance Fund (CA): Grade A
Claims administrator properly processed reimbursement for ML203. Date of Service: 04/15/2021
Apr 1, 2021
ML201 - State Compensation Insurance Fund (CA): Grade A
Claims administrator properly processed reimbursement for ML201. Date of Service: 04/20/2021
Jun 29, 2021
Med-Legal Bill Denied for Liability? Request IBR
Certain California workers’ comp payers deny reimbursement for Medical-Legal evaluations by claiming lack of liability for the initial injury. With this twisted, circular log...
Apr 1, 2021
ML201 - Guard Insurance Group: Grade F
Claims administrator failed to properly reimburse ML201. Guard Insurance Group incorrectly denied valid medical-legal code as exceeding fee schedule allowance. Date of Servic...
Apr 1, 2021
ML201 - State Compensation Insurance Fund (CA): Grade A
Claims administrator properly processed reimbursement for ML201. Date of Service: 04/17/2021
Jul 9, 2021
ML106: Liberty Mutual Must Learn the Rules
California’s all-new Medical-Legal Fee Schedule (MLFS) debuted back in April, but some claims administrators are still a few steps behind. To bill for supplemental Med...