Early in 2017, a piece of workers’ comp legislative reform is making its presence known to California claims administrators and providers. No, we’re not talking about Senate Bill 1160 again – though that bill is certainly worthy of your attention. We’re talking about Senator Tony Mendoza’s other piece of landmark reform. We’re talking about Senate Bill 1175.
Signed into law last August by Governor Brown, SB 1175 didn’t get the press of its larger, more reformatory cousin. But this reform, too, promises to have a lasting impact on the California workers’ comp community. SB 1175 consists of three sections, which amend three separate Labor Codes. Each amended Labor Code involves timely bill submission and payment.
Amends Labor Code 4603
Effective January 1, 2017
The first section of SB 1175 is concerned with timely bill submission for medical treatment. It amends Labor Code 4603 to require that providers submit bills for services within 12 months of rendering services or the date of discharge from an inpatient facility.
This timely bill submission requirement applies to providers of services, including (but not limited to):
- Copy Services
- Transportation Services
- Home health care services.
The requirement does not apply to dates of service prior to January 1, 2017.
Crucially, the amended Labor Code specifies that no payment is due for untimely bill submission.
Amends Labor Code 4603.4
Effective Upon the Bill’s Signing
Section 2 required George Parisotto, the acting Administrative Director of the California Division of Workers’ Compensation (DWC), to adopt timely filing rules and regulations, and to set parameters for any exceptions to the timely billing requirement of twelve months.
To date, the DWC has not released draft or emergency rules and regulations to help direct the workers’ comp community regarding exceptions to the timely billing requirement. Nevertheless, the requirement is effective, with or without rules and regulations from the DWC.
This section also clarified a pair of mandates first laid out years ago: That all employers must accept electronic billing, and that claims administrators must remit payment for original electronic bills within 15 working days of receipt.
Amends Labor Code 4625
Effective January 1, 2017.
Section 3 revises Labor Code 4625 to state that medical-legal evaluation and related service bills, like other bills, must be submitted within 12 months from the date of service. This requirement does not apply to bills with dates of service prior to January 1, 2017. The amended Labor Code does not allow exceptions for this timely billing requirement.
As in Section 1, Section 3 also definitively stipulates that charges for medical-legal bills “are barred unless timely submitted.”
It’s never been more important to keep track of your bills. DaisyBillers can use the Bill History page to monitor when a bill was submitted, and when it was accepted by the claims administrator. The Bill History offers irrefutable proof of timely filing.