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Blog: Daisy News

News, data, & insights about workers' comp billing

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  • April 4, 2017

    Billing Tip: Know Where to Send RFAs

    The first thing we tell a provider when they ask for workers’ compensation billing tips? Always, always, always submit a Request for Authorization (RFA) for the recommended treatment. RFAs are the single best five-minute investment a practice can make, because authorized treatment guarantees payment.  

    Beyond that, treating physicians are required to submit compliant RFAs.¹ Yet many physicians do not take the time to submit the official DWC Form RFA. Still others are unsure of where and how to submit the form. We often hear from providers who submit their RFAs along with their bills; in reality, this can lead to long delays in processing – or no processing at all.

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  • March 31, 2017

    3DCA Decision Places Emphasis on RFA Timelines

    On Wednesday afternoon, the California 3DCA, or Third District Court of Appeal, issued a ruling in the Ramirez v. Workers’ Compensation Appeals Board case. This is an interesting case for a number of reasons. Most importantly, it leaves the WCAB with just one avenue to intervene on an Independent Medical Review (IMR) decision – and it all has to do with untimely Utilization Review (UR) responses to Requests for Authorization (RFAs).

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  • March 30, 2017

    Topics Announced for Work Comp Billing Conference

    This September, DaisyBill is hosting a one-day conference in Burbank dedicated to understanding and managing the complexities of California workers’ comp billing. It’s called Billaroo, and it’s the only conference of its kind. We’ll feature in-depth sessions on bill processing, claims administration, and everything in between. Beyond that, we’ll share tips and tactics, best practices, and eye-opening data from over 2 million electronic workers’ comp bills. All are welcome, client or not. Today, we’re proud to release the list of topics we will cover.

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  • March 29, 2017

    DWC Adopts New DMEPOS, Same as the Old DMEPOS

    The days are flying by. 2017 started with a bang, as the California Division of Workers’ Compensation (DWC) adopted a slew of new fee schedules, and the reforms of Senate Bills 1160 and 1175 ushered in a new era of workers’ comp billing. Now quarter two is bearing down on us, just when you thought you were caught up. In a Monday afternoon Newsline, the DWC announced an adjustment to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) portion of the Official Medical Fee Schedule, effective for dates of service on or after April 1, 2017.

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  • March 28, 2017

    CPT Codes 99358 and 99359 Resource Notebook

    Since the California Division of Workers’ Compensation (DWC) adopted the 2017 Physician Fee Schedule for dates of service on or after March 1, the DaisyBill team has fielded hundreds of questions from providers across the state. A great many of these questions focused on a pair of newly-reimbursable CPT codes – 99358 and 99359 – for non-face-to-face prolonged services, including but not limited to record review. Today, we answer your questions and unveil our newest California workers’ comp billing resource: A detailed 99358 & 99359 Resource Notebook.

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  • March 24, 2017

    Billing Procedure Code 0232T for Platelet-Rich Plasma Injections

    Last week on the blog, we examined the rare phenomenon of procedure codes whose reimbursements are established “by report.” This occurs when the Physician Fee Schedule fails to provide a reimbursement amount for valid procedure code, allowing providers to essentially set their own price – as long as they can back it up. Today, we’ll take a closer look at one of these codes in particular: CPT Code 0232T for platelet-rich plasma injection.

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  • March 22, 2017

    2017 Fee Schedule Changes Again – Learn How to Keep Up

    Well, that didn’t take long. Earlier this month – only eight days after officially adopting the Quarter 1 Physician Fee Schedule – the California Division of Workers’ Compensation (DWC) issued a Newsline announcing the next wave of changes to the Official Medical Fee Schedule (OMFS).¹ Somewhat surprisingly, there are several major reimbursement changes facing California workers’ comp providers for dates of service on or after April 1, 2017. But there’s good news, too – our development team unleashed a brand new tool designed to ensure that you never miss a work comp reimbursement change again.

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  • March 21, 2017

    The 5 Point Checklist for CPT Codes 99358 and 99359

    The 2017 Physician Fee Schedule, officially adopted by the California Division of Workers’ Compensation (DWC) for dates of service on or after March 1, included a number of changes that differentiate it from its 2016 counterpart. Perhaps the most intriguing of these changes was the introduction of CPT codes 99358 and 99359 as reimbursable codes for non-face-to-face prolonged services such as record review. Not coincidentally, these codes are also the subject of our March webinar.

    Over the past three years, these non-face-to-face services were often difficult for claims administrators and providers to negotiate on a case-by-case basis. The built-in CPT guidelines and reimbursements that come with the new payable status are good for the entire workers’ comp community.

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DaisyBill is a trusted authority on workers’ comp billing. Thousands of work comp professionals attend our webinars and state agencies and professional organizations turn to us for our expertise. We created this blog to help everyone involved in workers’ compensation; sharing news, tips, and data of interest to the community.

Drop us a line with any news you would like us to share or any issue that concerns you.

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