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Disputing Copy Bills is Difficult

by | Feb 18, 2015 | Workers' Comp Industry

Applicant copy bills are often nothing more than a one‐page invoice. Claims administrators are asked to blindly trust that a one‐page invoice from an applicant copy company offering no supporting documents is accurate, understandable, and reasonable. As Warren Buffet once said, “Trust is like the air we breathe. When it’s present, nobody really notices. But when it’s absent, everybody notices.” Everybody knows we have a problem with applicant copy service billing and now is the time to fight these outrageous bills.

When disputing a copy bill, Claims is often told by applicant copy services that there is no fee schedule and taking reductions is not allowed. Nothing could be further from the truth. Claims administrators are only obligated to pay fair and reasonable med legal expenses. The absence of a fee schedule was never intended to be a free pass to excessively bill for copy services. The costs and lien filings of applicant copy services continue to rise on an annual basis.

Claims administrators have a tough time properly disputing excessive and unnecessary applicant copy service billing. First of all, timing is crucial; any objection must be issued timely and in writing. The claims administrator is obligated to offer more than just a boilerplate letter stating that the applicant copy bill is excessive. A claims administrator should employ a set of best practices when disputing invoices. Objections should specifically state which line items are excessive and exactly how much of a reduction is being taken for each line item in dispute. A remedy should be presented to the applicant copy service outlining what can be done to fix the bill. Line items that are cryptic and do not truly describe or itemize a particular service should be challenged. The claims administrator needs to demand an explanation for further clarification and documentation to back up the disputed charge.

Claims adjusters and defense attorneys do not have time to review the bills for appropriateness or the industry knowledge to spot problems with applicant copy service billing. Many claims administrators are handling large caseloads and there are multiple deadlines on each claim that must be adhered to. What is a claims administrator to do when confronted with an applicant copy bill they believe is excessive or for services that do not constitute a med legal expense? The shortsighted approach was to pay the applicant copy bills in full. This approach has had serious consequences for the Workers’ Compensation industry as copy services were encouraged to ramp up billing as it was going unchecked and unchallenged.

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