If you own or run a business, you know that there are many administrative tasks which must be undertaken. Many of these small jobs and duties may be time sensitive, ranging from applying for permits to paying bills. If you do not adhere to these timelines, the consequences can sometimes be severe. In other words, it is essential that you pay attention to these detailed chores. In the legal field, this can be even more true, as missing certain deadlines in the context of a legal case can mean that you will not be able to receive particular types of relief. In the recent published case of Meadowbrook Insurance Co. v. Workers’ Compensation Appeals Board and DFS Interpreting, et al., the court was presented with an issue concerning meeting procedural requirements for interpreting services. This decision applies directly to treatment interpreter charges.
Two workers were injured in the course and scope of their employment; both of these injured workers required Spanish interpreters in connection with their medical treatment care. Meadowbrook was the workers’ compensation third party administrator. DFS Interpreting provided those interpreting services. Although DFS provided invoices to Meadowbrook for their interpreting services, as required by the California Labor Code, Meadowbrook refused full payment and issued explanations of review pursuant to California Labor Code section 4603.3. DFS did timely object to this refusal. However, they failed to request a Second Bill Review. California Labor Code 4603.2 (e) provides that if a provider disputes the amount paid for services, the provider may request a second review within ninety days of the explanation of review. The statute also states that such a request “shall” be submitted to the employer in a very particular format, including such things as the date of the explanation of review, the amount and item in dispute, the additional payment request and reason for same, and any additional information that was requested in the first explanation of review. Importantly, the statute specifically provides “If the only dispute is the amount of payment and the provider does not request a second review within 90 days, the bill shall be deemed satisfied and neither the employer nor the employee shall be liable for any further payment.”
The Meadowbrook decision relied heavily upon the specific language of CA Labor Code 4603.2, which deals only with treatment. Nevertheless, there is an equivalent requirement for Second Bill Review contained in CA Labor Code 4622(b)(2). As a result, there is a colorable legal argument that the Meadowbrook analysis would support full satisfaction of a Medical-Legal (AME/QME) service in the absence of a Second Bill Review request. That matter has not currently been decided, but the safer course is to request a SBR on every Med-Legal Invoice which is underpaid below the Interpreters desired level.
If you have questions about Workers’ Compensation and how it affects your Interpreting business, contact us today. We have extensive experience helping our clients timely collect their interpreter invoices.