CONCORD, CA — Jopari Solutions, Inc., a supplier of Workers’ Compensation and Auto Medical eBilling and ePayment products, explained today that the impact of the October 15, 2011 deadline under the state’s recently released Electronic and Standardized Billing Regulations may not be fully understood by California workers’ compensation payers. On and after that date, all medical bills must conform to a set of well-defined coding and billing standards.
According to Jopari, because the new California rules do not set forth any waiver provision for delayed implementation criteria, payers failing to comply with the October 15, 2011 paper bill requirements will be subject to Audit exposure and related fines and penalties. Said Steve Stevens, CEO of Jopari, “Our intention in pointing this out is to ensure that payers are focusing on the dual implementation dates these new regulations have presented the industry. Many payers we have been in contact with have primarily been focused on October, 2012 when the eBill requirements go into effect, while in fact, many of the eBill implementation requirements needs to be done by October 15 of this year.”
Mr. Stevens explained, “Workflows, data capture, and reporting systems will need to be changed, without exception.”
Jopari elaborated on the most pressing of the factors payers should consider in light of California’s new rules:
- Payers are required to determine if a submitted bill meets all standard bill criteria; and must reject or accept the bill based on the criteria.
- Payers must make payment within 45 days (60 days if governmental entity) of receipt of properly completed bills or be subjected to self-imposed 15% penalties and 10% interest.
- New data elements are required to be captured by Payers, and must be included in state reporting so as to provide this specific new data under WCIS reporting requirements.
Jopari advocates that payers not wait for October, 2012 but proceed to implement eBilling immediately. In an eBill environment, these new criteria are evaluated electronically, and a definitive audit trail is established.
“Early implementation of eBilling eliminates financial and human asset stresses associated with a two-tier paper and electronic compliance management approach. Equally important, pro-active acquisition of eBilling acceptance capabilities will allow payers to hone their workflows and processes, and, in many cases, create competitively differentiating service offerings for knowledgeable California employers who are aware of the new rules,” added Mr. Stevens.
Source: Jopari Solutions, Inc.