Blog: Daisy News

News, data, & insights about workers' comp billing

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  • January 9, 2018

    DWC 2018 Drug Formulary Webinar Transcript Available

    Last month, the Division of Workers’ Compensation (DWC) hosted a detailed live webinar on the newly effective drug formulary. For those who could not attend the webinar, the DWC recently made available a full transcript, accessible from the DWC website.

    The drug formulary is effective as of January 1, 2018.

    Read more →

  • January 5, 2018

    Authorization: 6 Qualifying Conditions for Fast-track Automatic Authorization

    On January 1, 2018, the new “fast-track” automatic authorization takes effect. In certain cases, some providers will be able to provide treatment without first submitting a Request for Authorization (RFA) for utilization review, because the treatment is automatically authorized.  But like many things in workers’ compensation, this “automatic” authorization scheme comes with conditions, caveats, and important new rules.

    Recently, we hosted a free comprehensive webinar on automatic authorization. Here, we explore the 6 qualifying conditions when treatment is eligible for fast-track automatic authorization.

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  • January 4, 2018

    FYI: Fresno County Changes TPA

    Effective January 1, the employer County of Fresno transferred all claims from third-party administrator (TPA) Risico Claims Management, Inc. to Acclamation Insurance Management Services (AIMS). The change applies to all dates of service.  All claims transferred to AIMS retain the same claim numbers used under Risico.

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  • January 3, 2018

    Med-Legal Billing: How to Obtain Reimbursement for Diagnostic Tests

    The conditions under which claims administrators must pay medical-legal doctors for diagnostic tests are specific and narrow. To ensure reimbursement, it’s important to know the rules.

    Medical-legal billing has unique regulatory snags that only the intersection of medicine and law could produce. Among those complications is reimbursement for diagnostic services like x-rays and laboratory services. In some cases these diagnostics services are not reimbursable without prior authorization by the claims administrator.

    Know the regulations, and use the standard language included in this blog to denial-proof your medical-legal bill.

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  • December 28, 2017

    This Holiday, Remember Who Work Comp Affects

    We write a lot about the struggles of workers’ comp professionals. As providers, payors and regulators navigate the deep weeds of rules, codes, conflicts, and everything else that makes work comp an obstacle course of migraine-inducing complications, it’s easy to forget that workers’ comp affects people. Workers’ comp exists to treat injured workers, people whose dependents can also suffer as a result of their injury.

    Kids’ Chance California is an organization that awards scholarships to the children of injured workers. They’re a reminder that no matter how tough work comp work can be, losing the ability to work at all can have life-altering effects.

    Read more →

  • December 23, 2017

    2018 Radiology Reimbursements (Professional Services): Cheat Sheet

    Lately, we brought readers the Division of Workers’ Compensation (DWC)’s recent updates to the Physician fee schedule for evaluation & management and surgery. Today, we take a look at the new reimbursements for professional radiology services (billed with modifier -26), effective January 1, 2018.

    Refer to the chart below for quick and easy reference. On January 16, we hosted a comprehensive webinar covering all the changes to the OMFS. As always, DaisyBill clients can rest assured that our OMFS Calculator will include the most recent available reimbursement rates.

    Read more →

  • December 20, 2017

    2018 Surgery Reimbursements: Cheat Sheet

    2018 is around the corner, and the Division of Workers’ Compensation (DWC) recently posted updates to the Official Medical Fee Schedule (OMFS), effective January 1. We’re detailing those changes here in our blog. As always, our OMFS Calculator will be up to date with all the changes for DaisyBill users.

    Last week, we covered changes to reimbursements for E/M services. Today, we take a look at reimbursement changes for surgery. Later this week, we’ll post changes to reimbursements for radiology.

    Use the chart below for quick and easy reference, and download our recent OMFS webinar.

    Read more →

  • December 19, 2017

    Audit Complaints: Work Comp Providers Demanded Compliance in 2017

    DaisyBill providers stood firm in demanding timely, correct payments in 2017 by using our Audit Complaints Tool to report payor noncompliance.

    We always advocate for compliance on both sides of the workers’ comp transaction. That said, the consequences for provider violations are immediate and automatic, while the payors (insurers, self-insured employers, and their claims administrators) are subject to repercussions only when the Division of Workers’ Comp (DWC) takes action.

    This year, our providers submitted almost 3,000 Audit Complaints, alerting the DWC when claims administrators failed to follow regulations. The data on this year’s violations help paint a picture of which infractions create the most friction for providers.

    Read more →

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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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