The City of Los Angeles recently shook up their Bill Review program, making the switch from Stratacare to Medata as of April 1, 2017.
Frequently Asked Question
Q: How will this affect workers’ comp bills for the City of LA?
A: First and foremost, we caution providers to immediately cease sending electronic bills to Stratacare via their WorkComp EDI payer ID, as this connection is no longer operational.
Longer-term ramifications remain to be seen. The City of Los Angeles is a notoriously complicated employer with no fewer than four separate claims administrators – in addition to self-administering some of their claims in house, they also use AIMS, ACME, and Tristar. Time will tell if the move to Medata helps the City improve its electronic billing compliance.
DaisyBill records reveal electronic EOR non-compliance throughout Stratacare’s tenure with the City of Los Angeles. In fact, the city routinely failed to return electronic EORs altogether under its old bill review program with Stratacare. We routed over 5,300 bills to the City of Los Angeles in 2016, and Stratacare remitted zero electronic EORs in return.
DaisyBill contacted the City of Los Angeles shortly after the announcement of their new bill review program to obtain updated electronic billing information. The city instructed us to contact Medata directly. Despite some initial confusion, a Medata representative recently confirmed that the company does have the capacity to accept electronic billing on behalf of the City of Los Angeles. We’ve updated our records accordingly, and anticipate a smooth and easy billing transition for DaisyBill clients.
One important note: The Medata rep indicated that any provider wishing to appeal a bill originally reviewed by Stratacare must include a copy of the Stratacare EOR with their Second Review. This is technically non-compliant. Although DaisyBill always recommends attaching an EOR to second reviews, California regulations require nothing more than the SBR-1 Form for paper Second Reviews or the modified CMS 1500 for electronic Second Reviews.
We’ll monitor this situation as it continues to unfold (paying extra attention to Medata’s electronic EOR compliance) and post updates on the blog as needed.
Please contact us directly if you have additional questions.