California became one of the first three states in the country to provide for e-billing in workers’ compensation when medical treatment e-billing regulations became effective Oct. 18, 2012. Implementation of e-billing improves efficiency of the billing and remittance process and produces quicker bill payment.
By statute, claims administrators are required to accept electronic medical treatment bills. They may develop their own capacity to accept electronic bills or may contract with a vendor to perform the function. Participation in e-billing is optional for medical providers. A medical provider who chooses to submit paper bills must use the standardized paper billing forms and conform to the paper billing regulations.
Medical treatment providers – including hospitals, doctors, pharmacists, and others who provide medical services and goods to injured workers – are increasingly recognizing the benefits of using electronic standards to send their bills to payers. In turn, claims administrators who complete the cycle by processing and paying those bills electronically are seeing efficiencies from streamlined processes.
Electronic billing regulations and guides
Effective Oct. 1, 2015:
- Billing, second review, independent bill review regulations
- California Division of Workers’ Compensation Electronic Medical Billing and Payment Companion Guide
- California Division of Workers’ Compensation Medical Billing and Payment Guide
- Frequently asked questions about e-billing
- Introduction to electronic medical billing / bill processing service providers