Annually, daisyBill submits roughly three million bills for the treatment of injured workers across the US, delivering over 90% of those bills electronically as e-bills.

Below, we share data from our Claims Administrator and Network Directory highlighting the performance of the ten largest claims administrators in the game, as measured by the volume of bills daisyBill clients sent over the last 365 days.

The good news is that all of the largest claims administrators pay our clients quickly, averaging payment in 5 to 11 working days* from the date of bill submission.

As regular readers are undoubtedly aware, we have criticisms of some of the insurers and Third-Party Administrators (TPAs) listed below. However, the bottom line for providers nationwide is that e-billing for workers’ comp—when executed correctly—results in faster, more accurate payment.

daisyData: Top 10 Workers’ Comp Claims Admins (by Bill Count)

Below, we list the ten claims administrators that received the highest count of bills from daisyBill clients since November 19, 2023.

Over the last year, these claims administrators collectively received over 1.5 million bills (over 50% of all bills daisyBill clients submitted in that time frame) for over 300,000 injuries treated by nearly 22,000 providers. Of note, daisyBill transmits bills electronically to all ten of these claims administrators.

First, the kudos:

• Gallagher Bassett paid providers the fastest, on average, in just 5 working days. This TPA processed the second-highest number of bills—181,054 bills to be precise—so that kind of payment turnaround is worth celebrating.
  

• Statistically, bills submitted to California’s State Compensation Insurance Fund (State Fund) required a duplicate bill 0% of the time. State Comp proves that all claims administrators can eliminate the nasty habit of forcing providers to resubmit workers’ comp bills to receive payment.
  

• Speaking of California’s State Fund, the insurer also responded to 93% of clients’ e-bills with electronic Explanations of Review (e-EORs)—a requirement in many states and simply the right thing to do regardless of the state.

If anyone wonders if consistent payment compliance is possible, look to State Fund. Their performance, particularly in accepting and responding to e-bills, clearly demonstrates that its leadership prioritizes compliance (and properly manages providers’ bills).

Again, considering the massive volume of bills the claims administrators below handled, consistently good performance is an accomplishment that has a real impact on injured workers. When providers can count on a relatively smooth billing and payment experience, they can focus their time and effort on treatment.

But of course, not all is happy news. Loud boos and hard stares go to:

• ESIS. With an abysmal 49% e-EOR compliance rate, this TPA drains resources from practices, which must enter payment details from ESIS’s paper EORs manually. ESIS also has a high, 4% duplicate bill rate—which means providers must resubmit 4% of their bills to receive payment.

• Sedgwick, the single largest claims administrator in our system. With a disgraceful 69% e-EOR compliance rate, daisyBill has submitted tens of thousands of formal Audit Complaints to California state authorities to report this TPA’s long-standing non-compliance. Sedgwick also has the ignominy of a 4% bill duplicate bill rate, which translates to 22,668 bills providers were forced to resubmit.

• Travelers. By failing to properly respond to providers’ bills, this insurer forced daisyBill clients to send duplicate bills 5% of the time. That’s over 4,000 perfectly valid bills that Travelers fumbled, forcing providers into a do-over.

daisyData: Top 10 Claims Admins for bills sent 11/19/2023 to 11/19/2024

All providers are welcome to use our free Claims Administrator and Network Directory for more data, insights, and valuable information on claims administrators and (newly added) network payers. daisyBill tracks workers’ comp payer performance across the US so providers know exactly what to expect.

*Average Days to Pay are based on bills submitted through daisyBill-verified submission routes from the previous 365 days of available data, excluding lien claims and other statistical outliers.

Nationwide, daisyBill increases revenue and decreases hassle for providers who treat injured workers. Get a free demonstration below.

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