Blog: Daisy News

News, data, & insights about workers' comp billing

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  • April 25, 2018

    3 Facts About Automatic Authorization for Workers’ Compensation


    Recently, a DaisyBill client reached out with questions regarding automatic authorization. The source of the confusion was a slideshow presentation from the California Coalition on Workers’ Compensation (CCWC)’s 15th annual conference, held last July. The presentation contained no outright falsehoods, but used puzzling language and left out a key point regarding billing deadlines.

    Tellingly, the conference was sponsored by Sedgwick, the third-party claims administrator. Given claims administrators’ interest in keeping providers in the dark regarding the new rules, we thought we’d clear up some confusion.

    Read more →

  • March 23, 2018

    Automatic Authorization: Late Bill Submission Does Not Bar Payment

    cog-single-gear-GIF-approve.gifWorkers’ comp providers, be warned: payors are incorrectly denying bills for automatically authorized services due to untimely submission.

    Untimely submission is not grounds for denial of payment under California’s new automatic authorization system. While the deadlines for bill submission are much shorter for automatically authorized services, no provision whatsoever bars payment when providers miss said deadlines.

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  • February 8, 2018

    Treatments That Do NOT Qualify for Automatic Authorization in Workers’ Comp

    Automatic authorization for California workers’ comp is in effect, but not all treatments qualify.

    In fact, the Division of Workers’ Compensation (DWC) has specifically barred certain treatments from automatic authorization. In these cases, the usual Request for Authorization (RFA) and prospective utilization review (UR) remains required — with some exceptions. Since many of our recent webinar attendees asked about specific services, we thought a review of ineligible treatments was in order.

    For our complete downloadable guide to automatic authorization in 2018, click here.

    Read more →

  • February 7, 2018

    “Automatic” Authorization, but Denied Bill? How to Appeal the Denial

    The new “automatic” authorization process for workers’ comp is in effect, as of January 1. We’ve discussed this new system extensively on our blog and in our recent webinar, covering everything from eligibility to timeliness to new utilization review requirements. But what happens if the employer or insurer’s claims administrator denies payment for automatically authorized services rendered? Does the usual second review appeal process apply?

    In short, authorized is authorized, automatically or otherwise — but in this case, there is a twist.

    For our complete downloadable guide to automatic authorization in 2018, click here.

    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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