Carrier Cites Wrong Statute to Deny Hundreds of Medical Invoices, Billing Firm Says

By Mark Powell
State: California
Topic: Top
- Popular with: Legal
- 10 shares

A workers’ compensation insurance provider has denied hundreds of bills from medical providers…

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4 Comments (2 Replies)

Close Do not post libelous remarks. You are solely responsible for the postings you input. By posting here you agree to hold harmless and indemnify WorkCompCentral for any damages and actions your post may cause.

Steven Dewberry Oct 2, 2020 a 7:10 am PDT

Wait, are you say carriers deny things in bad faith? Regularly? How could this be?

Anne Bazel Oct 2, 2020 a 10:54 am PDT

Carriers routinely explore loopholes allowing denial of payment. How about $0 with excuse charge is over OMFS forcing provider into IBR dance, hoping to kill the bill. They are supposed to pay OMFS with explanation. Tell me this never happens.

Hazel Ortega Oct 4, 2020 a 10:39 pm PDT

They do the same thing with SJDB voucher payments. We send referrals to the Audit Unit and hope to see changes.

Anthony Macauley Oct 2, 2020 a 9:10 am PDT

These are allegations by a provider with a dog in the fight. Work Comp Central should apologize for the headline. Daisy Bill has been pushing this allegation. So I knew where it came from. Tacking "billing firm says" at the end of the headline, does not cut it. I did not even see that phrase. I clicked immediately for the article. The headline should have read, "Daisy Bill says ..." CSIMS and a lobbyist are not reliable sources of the accuracy of the claim. This is "fake news."

Ann Richmond Oct 2, 2020 a 10:10 am PDT

Actually its not fake news. I bill for a chiropractor who has received many denials from Zurich citing that the billing was late because it was more than 30 days from the date of service.

Marko Vucurevic Oct 2, 2020 a 11:10 am PDT

Zurich was not the only one to attempt this tactic. Numerous other payers blindly denied payments based on 4610 when it originally came out but have since corrected their systems.