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medical-legal
Sep 16, 2021
3 min read
0
Med-Legal Reports: Always Include Page Count Verification!
California’s new Medical-Legal Fee Schedule (MLFS), effective from April 2021, brought with it new rules for reporting, billing, and payment. Among those rules: when submitti...
Aug 25, 2021
4 min read
0
AIG: Improper (but Logical) Med-Legal Underpayment
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 ...
Aug 19, 2021
4 min read
0
Med-Legal Diagnostic Testing Is Reimbursable
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.<...
Aug 17, 2021
3 min read
0
Med-Legal: PPO Discounts Do NOT Apply to MLFS
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...
Aug 12, 2021
2 min read
0
Med-Legal ML106: IBRs Leave No Doubt
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...
Aug 2, 2021
3 min read
0
CA Med-Legal: ML200 Missed Appointment Payable
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...
Jul 15, 2021
4 min read
0
Sedgwick Violates LACoFD Employer Contract, IBR Drops Ball
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...
Jul 9, 2021
4 min read
0
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...
Jun 29, 2021
3 min read
0
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...
Jun 4, 2021
4 min read
0
Sedgwick Defies DWC COVID Rules; DWC Washes Hands
Sedgwick defied California workers’ comp regulations, costing a provider thousands in due reimbursement. Unfortunately, the Division of Workers’ Compensation (DWC) has declin...
May 13, 2021
1 min read
0
Download: Med-Legal Graphic Workflow (With Modifiers)
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 ...
May 12, 2021
4 min read
0
CNA Repeatedly Ignores California Law
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...
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