Blog: Daisy News

News, data, & insights about workers' comp billing

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  • May 11, 2018

    Discount Dangers: The Provider’s Bill of Rights (Rights VI and VII)

     

    Discount Dangers is a DaisyBill series on the ways discount contracts unscrupulously lower work comp providers’ reimbursements. With this series, we shine a light on the worst practices and help providers fight back.

    Eligibility and active encouragement: These two principles uphold the equitability of discount contracts. Providers have the right to know who’s applying a given discount to which bills, and to have patients steered to their office in exchange for those discounts.

    Over and over, Labor Code Section 4609 mandates adherence to these dual precepts. The next two Provider’s Rights in this series further clarify exactly how eligibility and active encouragement are supported by law.

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  • March 20, 2018

    Discount Dangers: The CA Provider’s Bill of Rights (Right V)

    Discount Dangers is a DaisyBill series on the ways some discount contracts unscrupulously reduce providers’ reimbursements. With this series we shine a light on the worst practices, to help providers fight back.

    According to California Labor Code, when a provider contracts with a payor to accept reduced reimbursements, it is incumbent upon the employer to take certain reasonable, clearly defined steps to direct their injured workers to the contracted provider for care.

    A provider accepts reduced reimbursements because she/he has an expectation that the number of patients will increase. Instead, all too often, providers simply accept reduced reimbursements without an adequate return on investment. This series is meant to help providers hold employers and payors accountable.

    Providers should insist that employers — and subsequently payors — earn these discounted reimbursements as mandated by the Labor Code.

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  • March 6, 2018

    Discount Dangers: The CA Provider’s Bill of Rights (Rights III and IV)

     

    Discount Dangers is a DaisyBill series on the ways discount contracts incorrectly reduce providers’ reimbursements. With this series, we shine a light on the worst discount practices, and help providers fight back.

    Providers should know what they’re getting into when signing a discount contract.

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  • August 29, 2017

    Discount Dangers: The CA Provider's Bill of Rights (Rights I and II)

    Discount Dangers is a DaisyBill series on the various ways discount contracts incorrectly reduce providers’ reimbursements. With this series, we shine a light on the worst discount practices, and help providers fight back.

    Providers have rights.

    We can’t state this strongly enough. In so many ways, the California workers’ compensation system is rigged against providers. That’s why it’s vital for providers to know exactly how the law protects them from unfair treatment and improper reimbursement. This is particularly crucial when it comes to discount contracts, which are often abused in ways that are more than just unfair; they’re also non-compliant.

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  • August 18, 2017

    Discount Dangers, Part I: The Silent PPO

    Discount Dangers is a DaisyBill series on the various ways discount contracts cheat workers’ comp providers out of reimbursement. With this series, we shine a light on the worst discount practices, and help providers fight back.

    There’s a danger lurking in Preferred Provider Organization (PPO) discount contracts: the “silent” PPO.

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  • July 14, 2017

    Align Networks Changes Name, Introduces New Payment System

    Would Align by any other name smell any sweeter? Align Networks is now known as One Call Physical Therapy, picking up a new moniker and logo as part of a rebranding effort. The move comes at an interesting time for the company – Align, of course, received notoriety this year for their role as the defendant in a bombshell lawsuit filed by the Independent Physical Therapists of California (iPTCA). What’s more, a deeper investigation revealed that their name isn’t the only thing that’s changing – the company now known as One Call Physical Therapy will also adopt a new payment system, ECHO Health, as of August 1.

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  • June 28, 2017

    Combat Discount Contract Reimbursements

    Many California work comp providers believe that signing discount contracts is the only way to participate in a network. While that’s not actually true, most providers still sign these discount contracts for workers’ comp services. At the very least, providers are unrelentingly approached about signing such contracts. A word to the wise: While tempting at first, discount contracts rarely provide additional new patients, usually reduce revenue, and can be nearly impossible for billing staff to manage and track.

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  • June 9, 2017

    Align Networks Contract Reveals Source of Surprise Discounts

    Last month in this space, we analyzed a few of the potential pitfalls of signing a discount contract with Align Networks. Align has been subject to controversy lately – first, with its questionable instruction to prematurely bill unadopted Medicare codes, and then again when the Independent Physical Therapists of California (iPTCA) took them to court alleging fraudulent and illegal behavior. Today, we take a closer look at an Align discount contract and explain why its discounted payment is applicable even when Align does not refer the patient for treatment.

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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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