1. (a) Each insurer shall submit to the commissioner annually by July 1 of each year a document certifying the following:

   1. (1) the total number of persons adjusting claims on its behalf;
   2. (2) the total number of claims adjusters and medical-only claims adjusters who are trained or experienced;
   3. (3) the percentage of the claims adjusters and medical-only claims adjusters who are trained or experienced;
   4. (4) all persons adjusting claims on behalf of the insurer are designated to do so or are in training; and

   5. (5) the course of instruction provided for training of all claims adjusters and medical-only claims adjusters meets all requirements of this article and that all claims adjusters and medical-only claims adjusters have attended training for the required number of hours to be qualified to adjust workers' compensation claims.

      The document, which shall be on the form specified in Section 2592.08, shall be signed under penalty of perjury by the person or executive officer responsible for the insurer's claims operations. The commissioner shall publish the information contained in this document on the Department of Insurance public website.

2. (b) Each insurer shall submit to the commissioner annually by July 1 of each year a document certifying the following:

   1. (1) the total number of medical bill reviewers reviewing medical bills on its behalf;
   2. (2) the total number of medical bill reviewers who are trained or experienced;
   3. (3) the percentage of the medical bill reviewers who are trained or experienced medical bill reviewers;
   4. (4) all persons reviewing medical bills on its behalf are designated to do so or are in training; and

   5. (5) the course of instruction provided for training of all medical bill reviewers of the insurer and of medical billing entities used by the insurer meets all requirements set forth in this article and that all medical bill reviewers of the insurer and of medical billing entities used by the insurer have attended training for the required number of hours to be qualified to perform medical bill review.

      The document, which shall be on the form specified in Section 2592.09, shall be signed under penalty of perjury by the person or executive officer responsible for the insurer's claims operations. The commissioner shall publish the information contained in this document on the Department of Insurance public website.

Note: Authority cited: Section 11761, Insurance Code. Reference: Section 11761, Insurance Code.

History

1. New section filed 1-23-2006; operative 2-22-2006 (Register 2006, No. 4).