How Do I Track Collections for QME Work?
Unlike regular clinical billing, QME revenue is driven by flat-fee invoices and statutory payment clocks. A simple but disciplined collections workflow ensures every Medical-Legal dollar reaches your bank account—and flags late payers before they become write-offs.
1. Build a QME-Specific A/R Ledger
Most practice-management or accounting platforms (QuickBooks, Xero, Kareo) can handle medical-legal invoices, but create separate customer records for each claims administrator. Key fields to track:
- Carrier / TPA name and address
- Claim number and injured worker
- Invoice date and service date (starts the 60-day clock)
- Code(s) billed: ML200, ML202, ML400, etc.
- Total fee and modifiers
- Payment status (Open, Partially Paid, Paid, Disputed)
2. Automate Aging and Reminders
Configure A/R aging buckets at 30, 45, 60, and 75 days. Set automated email or task reminders:
- Day 30: Courtesy reminder to claims examiner.
- Day 45: Phone call and resend invoice + proof of service.
- Day 61: Issue statutory 10 % penalty & interest notice.
- Day 75: Begin lien preparation (if needed).
3. Reconcile Deposits Weekly
Match every EFT or check to its invoice. Post partial payments immediately; carriers sometimes omit record-review modifiers and need a follow-up supplemental bill review (SBR).
4. Track Key Metrics
| Metric | Target |
|---|---|
| Days Sales Outstanding (DSO) | < 42 days |
| % Paid Within 60 Days | > 95 % |
| Penalty Assessments Issued | < 5 % of invoices |
| Write-Off Rate | < 1 % |
5. Use Billing & Collection Services (Optional)
Medical-legal billing firms (e.g., ML Bill Pro, CompData) charge 4–6 % of collected fees and maintain their own lien and penalty workflows—worth considering once you exceed 20 invoices/month.
6. Retain Documentation for Audits
Keep invoice copies, record-review logs, and proof-of-service certificates for five years (CCR §9795 (f)). Proper archives speed penalty claims and DWC audits.
For statutory payment timelines and penalty provisions, review Labor Code §4622 on the DWC site: Payment of Medical-Legal Expenses.