The City of San Diego, a self-insured, self-administered California employer, is in the process of switching bill review services from Genex to Medata. The transition, though, is an awkward one so far. San Diego and Medata have yet to establish the necessary connections with each other, and neither entity has the requisite electronic billing expertise to fully review and process bills together.

As workers’ comp billing experts, DaisyBill would like to extend any help or guidance necessary to both San Diego and Medata as they navigate the switch.

For providers, the billing process will remain the same. While the switch affects all dates of service, claim numbers do not change, and providers will continue to submit bills and second review appeals directly to the employer.

A Tricky Transition

Officially, San Diego’s switch from Genex to Medata is effective August 21, 2019. According to a San Diego claims representative, training regarding the switch was scheduled for that date. However, according to the representative, Genex may continue to conduct bill review until as late as November 30, 2019.

Strange as it may seem, a Medata representative confirmed that San Diego is not yet live with Medata. According to the most recent information available,  Medata, does not even have a contact person at San Diego. Therefore, Genex, despite no longer being the bill review service for San Diego, will conduct bill review for San Diego until further notice.

There is no word yet on when San Diego will complete what is — for now — only a nominal transition.

We strongly encourage San Diego and Medata to avail themselves of DaisyBill’s expertise, particularly in regards to choosing the right clearinghouse for San Diego’s needs. DaisyBill maintains connections with all California clearinghouses, including Jopari, WorkComp EDI, Availity, Carerisk

As regards billing, nothing changes for providers. Providers will continue to submit bills directly to San Diego. Non-electronic bills should be sent to:

City of San Diego
PO Box 129013
San Diego, CA 92112

Providers must also submit any second review appeals directly to San Diego. We’ll keep readers abreast of any new developments, here on our blog.

DaisyBill’s Billing Software is always updated to reflect the latest changes, including TPA and bill review changes. To help your office stay on top of the ever-shifting workers’ comp billing and payment landscape, schedule a free demonstration of our Billing Software by clicking the button below.

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