Why Medical Bill Payment Deadlines Matter
Medical bills make up a significant portion of workers’ compensation expenses. Managing these costs efficiently means not only paying the correct amount but also doing so within the mandated timeframe.
Failing to meet these deadlines can lead to:
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Financial penalties
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Interest accrual
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Potential legal issues
California Labor Code 4603.2 sets the standard for how medical treatment bills are processed and paid. Here’s what you need to know.
Understanding the Deadlines
California law specifies different deadlines depending on how the bill is submitted:
| Submission Type |
Payment Due |
| Paper Bills |
45 calendar days |
| E-Bills |
15 working days |
| Government Agencies |
60 calendar days |
These deadlines ensure that medical providers are compensated in a timely manner and that workers’ compensation claims remain compliant.
What Happens If You Miss the Deadline?
Missing a medical bill deadline in workers’ compensation doesn’t just cause administrative headaches—it can cost you financially.
Penalties for Late Payments:
These penalties apply automatically and do not require an order from the Workers’ Compensation Appeals Board (WCAB). This means that even a small oversight can lead to significant financial consequences.
Example Scenario:
Imagine an adjuster misses the 45-day deadline for paying a paper medical bill. The original payment amount of $1,000 would increase by 15% to $1,150, plus 10% interest from the original receipt date. Multiply that by several claims, and you can see how these penalties add up fast.
Best Practices for Staying Compliant
Here are some strategies to help you avoid late payment penalties:
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Automate Billing Processes:
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Conduct Regular Audits:
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Train Your Team:
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Use Trusted Software:
Why Claims Professionals Need to Know This
Staying compliant with medical bill payment deadlines not only protects your company from financial penalties but also maintains your reputation as a responsible payor. Whether you’re an adjuster, claims manager, or employer, understanding these deadlines is crucial.
At IEA, we dive deeper into topics like these in our Claims Practitioner in Workers’ Compensation (CPWC) certification. Equip yourself with the knowledge to manage claims efficiently and stay on the right side of compliance.
Conclusion
Medical bill payment deadlines in workers’ compensation are non-negotiable. Missing them can result in costly penalties, increased payouts, and compliance challenges. Stay informed, stay prepared, and make timely payments to avoid unnecessary financial strain.
Additional Resources
Claims Practitioner in Workers’ Compensation: Find it here
California Department of Workers’ Compensation Medical Bill Payment Guide – DWC Medical Billing
California Labor Code 4603.2 – Medical Bill Payment Guidelines: California Legislative Information – LC 4603.2
Sullivan on Comp – Medical Billing and Penalties (Subscription Required) – Sullivan on Comp
