California Workers' Comp
Sep 29, 2023
SCIF Inept UR #6: Non-MTUS Guidelines Strike Again
Once again, State Compensation Insurance Fund (SCIF) and EK Health denied surgery for an injured worker by citing unadopted, alternative treatment guidelines outside of Calif...
Sep 28, 2023
Berkshire Hathaway: 10,735 Audit Complaints Filed With CA DWC
Berkshire Hathaway Homestate Companies (BHHC) is backsliding into old, bad habits.Over the summer, BHHC failed to send thousands of electronic Explanations of Review (...
Sep 27, 2023
SCIF Inept UR #5: EK Health Ignores MTUS, Denies Surgery
Why is it so difficult to get treatment for a work-related injury? At least in California, most of the answer is a broken UR system that allows insurers to withhold potential...
Sep 26, 2023
ProPublica/NPR: Fees & Discounts Gutting Provider Revenue
ProPublica and NPR recently published an exposé on entities that impose fees on doctors who accept electronic funds transfer (EFT) payments. These fees c...
Sep 19, 2023
daisyBill Account Analytics: Appeal Payments!
If no one tracks your workers’ comp bills, you’re probably missing critically important information about your practice’s revenue.The sad fact is that between i...
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Sep 15, 2023
SCIF Inept UR #4: IMR Rules Favor Insurers
In recent articles, we’ve shared the details of State Compensation Insurance Fund (SCIF)’s denial of continued care for an injured worker on false grounds, and ...
Sep 14, 2023
FYI: Inaccurate DWC IBR Form May Cost Your Practice
California’s Division of Workers’ Compensation (DWC) has strict and specific requirements for providers who wish to dispute incorrect payment amounts through Independent Bill...
Sep 13, 2023
SCIF Inept UR #3: IMR Offers No Hope for Injured Worker
In California workers’ comp, the insurer has the final say over an injured worker's medical care.So what if the insurer gets it wrong? What if the insurer denies appro...
Sep 12, 2023
SCIF Inept UR #2: Bungled Medical Records Strikes Again
Once again, the consequences of inept Utilization Review (UR) fall on an injured worker.EK Health, conducting UR on behalf of State Compensation I...
Sep 11, 2023
UR: An Open Letter to CA Residents
Dear California Readers,One of your neighbors experienced a significant head injury while repairing California highways. This individual has diminished cognitive abili...
Sep 7, 2023
daisyBill Account Analytics: EOR Count & Source Report
If no one is tracking your workers’ comp bills, you’re probably missing something critically important to your practice’s revenue.The sad fact is, between impro...
Sep 6, 2023
SCIF: Inept Utilization Review Delays Care for Injured Worker
We write often about the systemic issues surrounding Utilization Review (UR) in California and the constant struggle of providers to obtain authorization to tre...