California Workers' Comp
Jan 15, 2024
CA OMFS 2024: Pathology, Clinical Lab Fee Schedule Update
On January 4, 2024, California’s Division of Workers’ Compensation (DWC) updated the Pathology and Clinical Laboratory portion of the Official Medical Fee Schedule (OMFS), ef...
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Jan 10, 2024
Athens Pays Interpreter More Than Physician For Evaluation
Once again, a claims administrator — with the help of a Preferred Provider Organization (PPO) — offers a perfect example of what makes treating injured workers financially un...
Jan 9, 2024
Albertsons Employee's Post-Amputation UR Nightmare
Two days before Christmas in 2022, an Albertsons Companies employee suffered “traumatic amputations” of three toes in a work accident. This worker lived alone on the t...
Dec 15, 2023
UR Data Supports CA Legislators' Fears
As early as 2016, California legislators were aware of potential abuse of the Utilization Review (UR) process. These legislators attempted to address the problem by en...
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Dec 13, 2023
AmTrust Pays Physician FAR Less Than Interpreter
Why do California doctors refuse to treat injured workers? Today’s story offers a giant, unmistakable clue.For the same encounter with an injured worker, AmTrust North...
Nov 21, 2023
CA Interpreters, Submit Those Second Bill Reviews!
Many providers of interpreter services in California are forgoing their legal right to correct reimbursement, potentially leaving large amounts of revenue on the table. Becau...
Nov 16, 2023
Data: Medicare and CA Physician Fee Schedule 2014-2023
Treating California’s injured workers is much, much more costly in terms of time and administrative resources than treating Medicare patients. And, most California providers ...
Nov 15, 2023
Reader Response: CA Physician Fee Schedule vs Medicare Rates
Make no mistake: 2024 cuts to Medicare reimbursement rates will affect reimbursement rates for treating injured workers — but only for providers under discount reimbursement ...
Nov 9, 2023
Gallagher Bassett Flips UR Decision, Confusion Reigns
To an injured worker denied the care their treating physician deems necessary, California’s Utilization Review (UR) process can seem arbitrary, even cruel. This percep...
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Oct 30, 2023
DWC's New MPN List Helps No One
California’s Medical Provider Network (MPN) system is an unmitigated disaster — and the latest “solution” from the Division of Workers’ Compensation (DWC) is laughable in its...
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 6, 2023
CA OMFS Update: Physician Services (Q4 2023)
California’s Division of Workers’ Compensation (DWC) issued an update to the Physician and Non-Physician Practitioner portion of the Official Medical Fee Schedule (OMFS) for ...