By Cynthia Jeremica
Winter 2001

Labor Code penalties are designed to ensure prompt payment of compensation and benefits.

Section 4603.2 (b) instructs that payment for medical treatment shall be made within 60 days after receipt of each separate, itemized billing, together with any required reports.  If the billing or a portion thereof is contested, denied, or considered incomplete, the physician shall be notified, in writing within 30 working days after receipt of the billing.  A notice that a billing is incomplete shall state all additional information required to make a decision.  Any properly documented amount not paid within the 60 day period shall be increased by 10 percent, together with interest retroactive to the date of receipt of the bill, unless both of the following are met,

(1) Pays the uncontested amount within the 60 day period

(2) Advises the provider of the items being contested, the reasons for contesting these items and the remedies available to the provider if the provider disagrees.  In the case of a bill which includes charges from a hospital, outpatient surgery center, or independent diagnostic facility, advice that a request has been made for an audit of the bill shall satisfy the requirements of this paragraph.

If an employer contests all or part of a billing, any amount determined payable by the appeals board shall carry interest from the date the amount was due until it is paid.

the payor has 30 days to notify you they have a problem with your bill.  Any properly documented amount not paid within 60 days shall be increased by a 10 percent penalty together with interest retroactive to the date of receipt of your bill.

have an ink stamp made up stating

10% PENALTY
Plus interest will
be added to claims not paid
IN 60 DAYS
Labor code 4603.2

1.   Stamp the face of all outgoing bills

2.   Make sure your bill is clean (correct and complete)

3.   A copy of the Operative Report is attached

4.   Any other necessary documents attached

Watch your bills being paid faster.  If you consistently collect these penalties due, you will notice some payors actually slapping their own hands and sending the penalties along with their late payments without your prompting!

this Labor code is written to ensure prompt payment.  Use it to your advantage and fight for every dollar you are entitled to!

1. The WCAB has a great web site full of information including forms you can download. Visit them at www.dir.ca.gov/DWC.

2. Consider ordering the Workers’ Compensation Laws of California. Available by calling (800) 533-1637 for about $46.00. It’s an annual publication.

How to stop the excuse...”We never received/have no record of your bill”...(how  many times have you heard this one?)