MLFS Report Card

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

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

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

Claims administrator properly processed reimbursement for ML200. Date of Service: 04/06/2021

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

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

Claims administrator properly processed reimbursement for ML201. Date of Service: 04/01/2021

ML201 - ESIS, Inc.: Grade A

Claims administrator properly processed reimbursement for ML201. Date of Service: 04/01/2021

ML200 - Mitsui Sumitomo Insurance: Grade A

Claims administrator properly processed reimbursement for ML200. Date of Service: 04/02/2021

ML204 - Contra Costa Schools Insurance Group: Grade A

Claims administrator properly processed reimbursement for ML204. Date of Service: 04/13/2021

ML204 - Sedgwick Claims Management Services: Grade F

Claims administrator failed to properly reimburse ML204. Sedgwick incorrectly denied valid medical-legal code as “not considered a valid reimbursable code.” Date of Service: ...

ML203 - AIG Claims, Inc.: Grade F

Claims administrator failed to properly reimburse ML203. AIG incorrectly denied valid medical-legal code as not in the fee schedule. Date of Service: 04/01/2021