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Blog: Daisy News

News, data, & insights about workers' comp billing

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  • September 8, 2017

    Clearinghouse Makes False Claims About E-Billing

    Multiple providers allege that a major clearinghouse fed them inaccurate information about electronic billing in California. According to these providers, the clearinghouse in question insists that many claims administrators do not accept e-billing for worker’s comp, necessitating paper bills. In truth, every major claims administrator in California does, in fact, accept e-bills.

    This casts serious suspicion on the clearinghouse’s motives.

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  • September 7, 2017

    New Patient Intake Form Available

    A well-crafted intake form, targeted to the California Division of Workers’ Compensation (DWC)’s billing guidelines, is the provider’s first line of defense against incorrect reimbursement. According to the DWC, a bill must be one thing above all to be considered compliant: complete. For providers, ensuring that completeness starts at intake.

    Fortunately, DaisyBill has that covered.

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  • August 14, 2017

    In Case You Missed It: San Mateo and Sonoma Counties Change TPAs

    Two California counties recently transferred their claims from Northern Claims Management to new administrators. Not surprisingly, communication about these changes was minimal—  and providers may find themselves improperly reimbursed as a result.

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  • August 9, 2017

    Reminder: Secondary Treating Physician Reports Not Payable

    Last month in this space, we covered reimbursement for the DWC Form PR-2, or the primary treating physician’s progress report. Since that time, we’ve received a number of questions from clients about reimbursement (or the lack thereof) for other various required reports. Unlike most workers’ comp subjects, this one is actually pretty straightforward.

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  • August 8, 2017

    Double Check: Confusion Over CCI Edits and MUEs Leading to Short Reimbursements for Outpatient/ASC

    DaisyBill has been paying almost obsessive attention to the Hospital Outpatient Departments and Ambulatory Surgical Centers Fee Schedule (Outpatient/ASC Fee Schedule). As we should; we worked hard to integrate it into our OMFS Calculator.

    So when the California Division of Workers’ Compensation (DWC) recently adopted an order changing that fee schedule, we scrutinized the changes— and asked a few important questions.

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  • August 2, 2017

    Hospital Outpatient Prospective Payment System: C-APC Explained

    Yesterday on the blog, we described how Medicare’s adoption of Addendum B for the Hospital Outpatient Departments and Ambulatory Surgical Centers (ASCs) fee schedule moves the workers’ comp system toward bundled payments via the use of the status indicator J1. Today, we’ll examine instances when a complex procedure warrants additional reimbursement above the amount allowed by the single reimbursement of a primary service (J1). To accommodate these complex procedures, Medicare developed the Comprehensive APC (C-APC) payment methodology.

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  • August 1, 2017

    Hospital Outpatient Prospective Payment System: J1 Status Indicator Explained

    Late last year, the Division of Workers Comp (DWC) drastically changed the reimbursement calculations used for Hospital Outpatient Departments and Ambulatory Surgical Centers (ASCs). Effective for dates of service on or after 12/15/2016, the DWC amended the Official Medical Fee Schedule for outpatient and ASCs to conform to Medicare’s reimbursement methodology.

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  • July 20, 2017

    Reminder: Consultation Codes Not Payable Without Authorization

    Here’s an uncontroversial statement: Workers’ comp billing is constantly changing. In fact, rules and regulations change so quickly that many medical billers and providers struggle to keep up. Case in point? A recent support case our team received about billing using defunct consultation codes.

    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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