Medical legal billing in California can be a challenging topic if you don’t know some basic terms. From EOR to IBR, in this post we outline the meaning of all the acronyms and medical terms you need to know to make sense of medical legal billing in the Golden State. AME The acronym AME Stands…
The surge in infections related to the Omicron variant led the California Division of Workers’ Compensation (DWC) to adopt emergency regulations for medical-legal evaluations that allow Qualified Medical Evaluators (QME) and Agreed Medical Evaluators (AME) to perform medical-legal evaluations using telehealth. These regulations will remain in place from January 18, 2022, until July 19, 2022,…
In this blog post, we take a closer look at medical coding modifiers — groups of numbers and letters that can make a big difference to the success of your practice. What Are Medical Coding Modifiers? In order to understand what medical coding modifiers are, first we have to talk about medical codes. Medical codes…
In a previous post, we saw how the Second Bill Review (SBR) / Independent Bill Review Process helps providers of medical-legal services dispute payments made by claims administrators. However, the Independent Bill Review process applies only to disputes related to the amount to be paid to a medical-legal provider. For all other medical-legal disputes it…
Today we take a closer look at the Second Bill Review/Independent Bill Review Process, from some basic definitions to the things medical providers should keep in mind when they dispute a medical-legal payment. What Is a Second Bill Review (SBR)? The Second Bill Review, or SBR for short, is a process that allows healthcare professionals…
There’s a worrying trend that workers’ comp doctors in California are facing increasingly often: Incorrect Preferred Provider Organization (PPO) reductions that slash their revenue and consume administrative resources. In theory, workers’ comp providers are protected by the California Labor Code, which sets rules to “prevent the improper selling, leasing, or transferring of a health care…
A med-legal report is a medical-legal evaluation of an injured worker that is performed by an independent doctor because the worker or the insurance company disagrees with the report of the treating doctor. Here, the term “treating doctor” refers to the physician who first diagnoses the worker to determine if there’s a connection between their…
Today we take a closer look at medical-legal billing, one of the most complex topics within medical billing. Keep reading to learn more about medical-legal billing in California, from a basic definition to some tips you can use to ease the administrative burden this process puts on your practice. Medical-Legal Expenses and Medical-Legal Billing in…