An employer that pays its own workers’-comp claims instead of buying insurance — usually through a TPA. In monopolistic states it is the only alternative to the state fund.
A self-insured employer meets the cost of its own workers’-compensation claims rather than transferring that risk to a carrier. Day-to-day administration is usually contracted to a TPA, so the adjuster you deal with may not be the employer’s own staff.
In a monopolistic state this is the only alternative to the state fund. Washington is the clearest example: a vocational referral is either a State Fund claim, billed to L&I, or a self-insured claim, billed to the employer or its TPA.
Establish which kind of claim a referral is before you do the work, because it decides who you invoice, on whose terms, and through which channel. State-fund billing runs on published rules and a portal; a self-insured payer runs on its administrator’s habits.
Then age them separately. One undifferentiated “outstanding” column mixes a fund with a dozen employers and hides which of them is actually slow. See aging.
The Washington billing guide works through the two-payer split in the most self-insured-heavy of the Tier-1 states.
Fifteen minutes, your state’s codes on screen — or start the trial and poke around on your own.