TPA Changes: City of Alameda, Torrance Unified Schools

TPA Changes: City of Alameda, Torrance Unified Schools

Two California public employers switched third-party administrators (TPA) recently, affecting bills for all dates of service. The City of Alameda and the Torrance Unified School District both changed who handles their workers’ compensation claims; details which may affect billing providers are below.

Alameda Switches to Non-Compliant TPA

Torrance Unified Schools switched from Keenan to Sedgwick, effective July 1, 2021. All claim numbers remain the same.

Meanwhile, the City of Alameda switched from Sedgwick Claims Management Services to LWP Claims Solutions. Note that LWP assigned new claim numbers to all claims.

Unfortunately, there’s one major problem with Alameda’s decision: LWP does not accept electronic bills, in violation of California law.

LWP’s clearinghouse, WorkCompEDI, assigned Payer ID WZ711, an ID which indicates a non-standard connection. When providers submit electronic bills for LWP, WorkCompEDI converts the bill data into a simple fax — which has (predictably) resulted in lost bills.

To ameliorate this, DaisyBill bypasses WorkCompEDI and faxes all provider bills directly to LWP. DaisyBill receives and retains the fax receipt sent by LWP as proof of LWP’s receipt of these bills. This is the only viable solution while we wait for LWP to come into compliance with California law.

We’ll keep readers updated with any news regarding LWP’s e-billing troubles, and any further switches in TPAs or clearinghouses.

DaisyBill makes authorization, payment, and appeals faster, easier, better. Contact us to learn how DaisyBill can save your practice thousands in revenue for workers’ comp services.


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