Medical Billing Forum
Billing => Billing => : oneround August 27, 2010, 03:57:05 PM
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Good afternoon ladies and gents and TGIF. Do any of you that bill/have billed or know if WC is also held to prompt pay standards? Or do they pay when they pay? I can't locate anything in the Federal Reg. on this.
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Good question. I hope somebody answers! :) No seriously I have wondered the same thing myself. I always thought that they were, however, most don't seem to follow that rule and I have never seen them pay interest.
Michele
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never seen it in NC
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No they do not have to adhere to state prompt pay laws because of the nature of the industry.. WC cases can investigate until they deem the claim payable or not. HOWEVER they do have to adhere to responding.. depending on the state they have to tell you what they are doing with the claim within that time frame ie; Pay, Pend, need info..etc.
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In CA, they have to pay in 45 business days or pay penalties and interest, State Fund is a pain, but they do police themselves well and their software automatically adds p&I. Unfortunately that's considered "prompt pay". Be sure to include the authorization and current PR-2's with EACH bill.
Dina
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Thanks All.
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I don't believe the law says that they have to "PAY" in 45 days..unless there is a clause about right of recovery..because WC issues are many times investigated the carrier has a right to investigate before monies are paid out..BUT I do know California laws are quite a bit different.. I would just "DOUBLE" check the verbiage to see if it says MUST PAY and also note verbiage to show they also have the right to recover funds paid out in error or due to fraud AFTER the case investigation is complete.