Posted November 7, 2017 in Photocopy
By James Williams, CEO of Devoted Attorney Services
SB863, although it was drafted in 2011, there were several key parts of the bill that changed the Copy Services industry. Independent Bill Review (IBR), Lien Filing Fees, and the Copy Service Fee Schedule. These three components of the bill will drastically change the way an Applicant Copy Service gets paid for Copy Related Services and how they operate.
Reading the proposed language, going to public meetings prior to these changes was a daunting battle.
The DWC website states the fee schedule will help copy services get paid faster.
From the start of the fee schedule my company experienced a financial hardship from the reduction in billing. The timeliness of payments did not improve, we experienced an increase in objections for copy related services. The effect was not only a loss in income, but a loss in profits due to the increased cost of doing business.
The Copy Service Fee Schedule, Sections 9980, 9981, 9982, 9983, 9984, 9990, 9992, 9994, and 10208.7. took effect July 1, 2015.
The fee schedule now puts a flat rate fee to copy related services.
Although 9983 (a) states and lists what is included in the flat rate, there are some minor exceptions that allow a Copy Service to bill for additional items. The fee schedule regulates how much to charge for additional sets of records based on when they were requested. There is also a flat fee for Certificate of No Records. The biggest strain the fee schedule put on copy services is the Request of Information Services (ROI) be included as part of the flat rate.
9981, Bills for Copy Services, explains the information that must be presented on every invoice. Bills for copy services must specify services provided and include a very specific list of items. Software vendors, programmers, over the counter programs, whichever you use to generate your invoice, will now need to be modified to include these items. New line item Billing Codes for services were created and listed in this section and must be incorporated into the invoices as well.
Each invoice must include a statement that there was no violation of Labor Code section 139.32 with respect to the services described. If the invoice is missing any of these items, it allows the claims administrator to object or subject your invoice to Bill Review, prolonging invoices from getting paid in a timely manner.
Another key part of the Fee Schedule is what is defined as Allowable Services (9982). 9982 defines what your allowed to order and when. This section allows the claims administrator 30 days to provide records in their possession. Request must be in writing by the injured worker or his or her authorized representative prior to sending a copy service to subpoena the records. This doesn’t mean that the injured worker cannot order the records, but it’s clear that “There will be no payment for copy related services” if you don’t follow these guidelines.
9982(e) states what the claims administrator is not liable for payment of certain invoices. This section is key because they define what they consider duplicative. It does not mean the attorney cannot reorder that same location of records, but they will be required to set forth “good cause for seeking duplicate records.” They also define good cause to be new counsel or loss or destruction of the records due to natural disaster. These are issues that would open the door for objections to invoices and invoices not getting paid in a timely manner.
Independent Bill Review (IBR), described in SB863 defines what Medical Legal expenses qualify and what disputes fall into this category. It is costly to go through the IBR process and only billing disputes can be resolved through this process. 9792.5.5. will explain what forms and documents will be needed as part of your packet for filing the review.
For Non IBR issues you can file a Petition for Medical Legal Disputes under section 14051.1. which there is no fee for, but you must meet all the criteria to qualify. Although filing liens is optional after SB863, these options to me are better ways to resolve the billing disputes. Again, following the new regulations, having all the items under 9981, follow the fee schedule and you shouldn’t have any billing disputes.
In conclusion SB863 changed the way we operate, bill and collect as a copy service.