Department of Insurance Payment Compliance Bulletin

The Illinois Department of Insurance released a compliance bulletin reminder to all companies licensed/approved to provide workers' compensation coverage in Illinois.  The bulletin covers provider notification and payment requirements included in Sections 8.2(d)(2) & (3) of HB 1698/PA 97-18.

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 Illinois Workers' Compensation Commission also released a notice regarding this IDOI bulletin.