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Combating suspicious and abusive billing practices

by | May 22, 2015 | Workers' Comp Industry

We look far beyond reasonableness of pricing and lack of supporting documentation. We analyze the data we have collected from over 100,000 copy service bills–combined with our own firsthand expertise as a copy service–to look for patterns, trends, and red flags in applicant copy service billing. Some notable examples include:

 

Questionable locations of records

If a copy company is issuing an unusual number of “certificate of no records” invoices, we will demand proof that applicant’s attorney really requested each location of records. These invoices can run from $200-$300 each and should not be paid without question.

We saw one company’s rate of “no records” invoices decrease from 1 out of every 3 invoices to only 1 in 10 within a month once we began demanding proof of the attorney’s request for records.

 

 “Split billing”

Many copy companies will “split” one job into multiple invoices. You might get one bill for the subpoena serve, another bill for the records, a third bill for an extra set of records to the applicant’s doctor, and so on. The idea is that you’ll be tricked into paying each individual invoice without realizing how much they all actually add up to.

In one of our favorite examples, one copy company subpoenaed 286 pages of records from a doctor’s office. They split this job into four separate invoices adding up to more than $1100! We track this type of billing and treat it as one job–one set of records from one location.

 

Insufficient evidence at lien trial

We provide expert testimony at trial to defend our reviews and to help significantly reduce liens. We have an undefeated trial record with over 100 victories, 30 of which are “take nothing” decisions or dismissals. The liens we fight are reduced by an average of 85%.

An important element of our trial strategy is to scour the lien claimant’s trial evidence for defects, discrepancies, missing documentation, conflicting dates, and other problems. Because we are a professional photocopy service, we know what the lien claimants need to do in order to meet their burden of proof, and we know exactly what to look for.

So often, the applicant copy services are unable to prove that they were asked to do the work that they have billed for, that they did not abuse the discovery process by using invalid subpoenas, that they actually copied the records they claim to have copied, and that their rates are anywhere near reasonable.

Unregistered copy companies

Approximately half of California’s applicant copy services are not registered professional photocopiers pursuant to Business and Professions Code sections 22450-22463. These unregistered providers have not met the strict requirements put in place by the state to ensure that only qualified photocopy companies have access to injured workers’ sensitive medical documents and personal information.

Instead of figuring out how they can meet these requirements, some copy services have chosen to put their energy into finding ways around them. We have refuted these arguments each time–in writing as well as at the WCAB.

Under the new fee schedule, the professional photocopier regulations will be further enforced, requiring copy services to be registered in order to get paid. However, we fully expect the applicant copy services to continue searching for that golden loophole, and we will continue to stand up to them.

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