MLFS Report Card
How to Win Med-Legal Payment Disputes
May 17, 2021
How to Win Med-Legal Payment Disputes
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...
Introducing: CA Med-Legal Fee Schedule Report Cards
Apr 29, 2021
Introducing: CA Med-Legal Fee Schedule Report Cards
At DaisyBill, we strive to help providers and their staff navigate the complexities of workers’ comp billing and payment, to ensure proper reimbursement. To that end, we’re d...
ML200 - Pacific Compensation Insurance Company: Grade F
Apr 1, 2021
ML200 - Pacific Compensation Insurance Company: Grade F
Claims administrator failed to properly reimburse ML200. Pacific Compensation Insurance Company incorrectly denied valid medical-legal code as not reimbursable. Date of Servi...
ML201 - Sedgwick Claims Management Services: Grade B
Apr 1, 2021
ML201 - Sedgwick Claims Management Services: Grade B
Claims administrator properly processed reimbursement for ML201. The lower grade reflects that the explanation of review (EOR) incorrectly lists 99199 as the ‘Reimbursed Code...
ML201 / MLPRR - Sedgwick Claims Management Services: Grade F
Apr 1, 2021
ML201 / MLPRR - Sedgwick Claims Management Services: Grade F
Claims administrator failed to properly reimburse ML201 and MLPRR. Sedgwick incorrectly denied valid medical-legal codes as “not in the fee schedule.” Date of Service: 04/06/...
ML200 - ESIS, Inc.: Grade A
Apr 1, 2021
ML200 - ESIS, Inc.: Grade A
Claims administrator properly processed reimbursement for ML200. Date of Service: 04/06/2021
ML200 - Sedgwick Claims Management Services: Grade A
Apr 1, 2021
ML200 - Sedgwick Claims Management Services: Grade A
Claims administrator properly processed reimbursement for ML200. Date of Service: 04/07/2021
ML200 - Berkshire Hathaway Homestate Companies: Grade B
Apr 1, 2021
ML200 - Berkshire Hathaway Homestate Companies: Grade B
Claims administrator properly processed reimbursement for ML200. The lower grade reflects that the explanation of review (EOR) incorrectly lists 99199 as the ‘Procedure Code/...
ML201 - Benchmark Insurance Company: Grade A
Apr 1, 2021
ML201 - Benchmark Insurance Company: Grade A
Claims administrator properly processed reimbursement for ML201. Date of Service: 04/01/2021
ML201 - ESIS, Inc.: Grade A
Apr 1, 2021
ML201 - ESIS, Inc.: Grade A
Claims administrator properly processed reimbursement for ML201. Date of Service: 04/01/2021
ML200 - Mitsui Sumitomo Insurance: Grade A
Apr 1, 2021
ML200 - Mitsui Sumitomo Insurance: Grade A
Claims administrator properly processed reimbursement for ML200. Date of Service: 04/02/2021
ML204 - Contra Costa Schools Insurance Group: Grade A
Apr 1, 2021
ML204 - Contra Costa Schools Insurance Group: Grade A
Claims administrator properly processed reimbursement for ML204. Date of Service: 04/13/2021