AIG: Improper (but Logical) Med-Legal Underpayment
Aug 25, 2021
AIG improperly reduced a California Medical-Legal bill by 88%, providing a dramatic example of how California law incentivizes payers to incorrectly reimburse physicians who ...
Med-Legal Diagnostic Testing Is Reimbursable
Aug 19, 2021
FAQ: Is diagnostic testing, as part of a Medical-Legal evaluation, separately reimbursable?A: Yes, as long as the testing is necessary to complete the evaluation.
Med-Legal: PPO Discounts Do NOT Apply to MLFS
Aug 17, 2021
Preferred Provider Organization (PPO) and other network discounts do not apply to the Medical-Legal Fee Schedule (MLFS). Period.In other words, the MLFS and OMFS are c...
Med-Legal ML106: IBRs Leave No Doubt
Aug 12, 2021
If it wasn’t clear before, it certainly is now. Physicians should bill for supplemental Medical-Legal reports requested before April 1, 2021 with billing code ML106, regardle...
CA Med-Legal: ML200 Missed Appointment Payable
Aug 2, 2021
An Independent Bill Review (IBR) case affirmed one of the biggest changes to California’s Medical-Legal Fee Schedule (MLFS): an established reimbursement for missed Medical-L...
Sedgwick Violates LACoFD Employer Contract, IBR Drops Ball
Jul 15, 2021
A physician agreed to serve as Independent Medical Examiner (IME) for the Labor Management Committee (LMC) representing the Los Angeles County Fire Department (LACoFD) and Lo...
ML106: Liberty Mutual Must Learn the Rules
Jul 9, 2021
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...
Med-Legal Bill Denied for Liability? Request IBR
Jun 29, 2021
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...
Sedgwick Defies DWC COVID Rules; DWC Washes Hands
Jun 4, 2021
Sedgwick defied California workers’ comp regulations, costing a provider thousands in due reimbursement. Unfortunately, the Division of Workers’ Compensation (DWC) has declin...
How to Win Med-Legal Payment Disputes
May 17, 2021
In light of the all-new Medical-Legal Fee Schedule (MLFS) for California workers’ comp, we debuted a new tool to help providers. Our MLFS “Report Cards” analyze...
Download: Med-Legal Graphic Workflow (With Modifiers)
May 13, 2021
Effective April 1, 2021, the Division of Workers’ Compensation adopted an all-new Medical-Legal Fee Schedule, complete with new billing codes and modifiers. Like many things ...
CNA Repeatedly Ignores California Law
May 12, 2021
By law, claims administrators must remit payment for Medical-Legal services within 60 days of receiving the physician’s bill. As of this writing, payment to one physician fro...