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© DaisyBill 2017 Workers’ Compensation Resources Penalty & Interest Medical Services Sample Calculation *((122 Days / 365 Days) X 10%) X $100 = $3.34 Amount Due Per OMFS $100.00 Payment Date 2/1/2017 Date Claims Administrator Received Bill 10/3/2016 Count of Elapsed Days 122 Penalty (15%) $15.00 Interest (10% per annum) $3.34

Payment Date 2/1/2017 Date Claims Administrator Received ... Penalty and Interest Medical Services.pdfPenalty & Interest Medical Services Sample Calculation *((122 Days / 365 Days)

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Page 1: Payment Date 2/1/2017 Date Claims Administrator Received ... Penalty and Interest Medical Services.pdfPenalty & Interest Medical Services Sample Calculation *((122 Days / 365 Days)

© DaisyBill 2017 Workers’ Compensation Resources

Penalty & InterestMedical Services Sample Calculation

*((122 Days / 365 Days) X 10%) X $100 = $3.34

Amount Due Per OMFS $100.00

Payment Date 2/1/2017

Date Claims Administrator Received Bill 10/3/2016

Count of Elapsed Days 122

Penalty (15%) $15.00

Interest (10% per annum) $3.34