Audit Complaints
Dec 19, 2023
Sedgwick Racks Up Another 11,947 Audit Complaints
Since October 2012, California law has required workers’ comp claims administrators to accept electronic bills (e-bills) from providers, and to respond to those e-bills with ...
Oct 27, 2023
JT2: 1,906 Audit Complaints Filed With CA DWC
California workers’ comp has many complex laws, regulations, and rules regarding billing and payment. But one law is straightforward: claims administrators must accept e-bill...
Oct 18, 2023
Sedgwick: 13,248 Audit Complaints Filed With CA DWC
In keeping with years of consistent violations of California laws and regulations, Sedgwick Claims Management Services continues to fail to send mandatory electronic Explanat...
Sep 5, 2023
Tristar: 2,315 Audit Complaints Filed With CA DWC
Third-Party Administrator (TPA) Tristar Risk Management continues to ignore California workers’ comp billing regulations with impunity, burdening providers with administrativ...
Jul 12, 2023
Tristar: 3,678 Audit Complaints Filed With CA DWC
Third-Party Administrator (TPA) Tristar Risk Management continues to ignore California workers’ comp billing regulations with impunity. Tristar failed to send electron...
Jan 5, 2023
Tristar: 8,188 Audit Complaints Filed With CA DWC
Using data generated by over 36,000 electronic bills sent by our provider clients in 2022, daisyBill demonstrates consistent non-compliance with California e-billing regulati...
Dec 14, 2022
Sedgwick's 57,876 Audit Complaints: A Business Practice?
Sedgwick received our open letter, but the Third-Party Administrator (TPA) still missed the memo. Sedgwick administers claims on behalf of insurers and self-insured em...
Dec 14, 2022
Sedgwick Missing e-EORs: 31,906 Audit Complaints Submitted
Sedgwick Claims Management Services is breaking the law. We encourage the California Division of Workers’ Compensation (DWC) to assert its role in upholding workers’ comp law...
Sep 7, 2022
ESIS Pays Med-Legal Bills Following Audit Complaints
California physicians can always rely on ESIS to pay its bills for Medical-Legal services — as long as they're willing to report ESIS to the Division of Workers’ Compensation...
Aug 11, 2022
Athens: 5,985 Audit Complaints Filed with CA DWC
Using data generated by over 18,000 bills sent by our provider clients in 2022 to Athens Administrators, daisyBill demonstrates consistent non-compliance with California e-bi...
Aug 11, 2022
ESIS: 10 Audit Complaints Filed With CA DWC
California law requires claims administrators to send an Explanation of Review (EOR) and payment to the physician within 60 days of receiving a bill for Medical-Legal service...
Aug 4, 2022
Tristar: 8,271 Audit Complaints Filed With CA DWC
Using data generated by over 23,000 electronic bills sent by our provider clients in 2022, daisyBill demonstrates consistent non-compliance with California e-billing regulati...