Springfield, IL – The Department of Insurance has issued a bulletin to insurance companies, reminding them to comply with the following two provisions in the medical fee schedule portion of the Illinois Workers’ Compensation Act:
Section 8.2(d)(2): If the claim does not contain substantially all the required data elements necessary to adjudicate the bill, or the claim is denied for any other reason, in whole or in part, the employer or insurer shall provide written notification, explaining the basis for the denial and describing any additional necessary data elements, to the provider within 30 days of receipt of the bill.
Section 8.2(d)(3): In the case of nonpayment to a provider within 30 days of receipt of the bill which contained substantially all of the required data elements necessary to adjudicate the bill or nonpayment to a provider of a portion of such a bill up to the lesser of the actual charge or the payment level set by the Commission in the fee schedule established in this Section, the bill, or portion of the bill, shall incur interest at a rate of 1% per month payable to the provider. Any required interest payment shall be made within 30 days after payment.
The bulletin is available here: IL Department of Insurance (PDF)
Source: IL WCC