Explanation of Review
Feb 10, 2021
Fresno USD Fails to Comply with Electronic Billing Regulations
For providers treating injured workers, electronic billing is by far the best billing option. For claims administrators in California, it’s not optional at all; accepting ele...
Sep 19, 2019
York (aka Sedgwick) Fails Math: EORs Literally Don't Add Up
York Risk Services, which was acquired this month by Sedgwick, has significant math troubles. York recently returned Explanations of Review (EORs) which obfuscated the effect...
Aug 8, 2019
NonCompliant CNA, Crum & Forster, County of San Diego - Electronic EORs Not Optional
As California continues its transition to fully paperless workers’ comp billing and payment, some claims administrators have apparently decided to follow their own regulation...
Jul 17, 2019
Mitchell Unresolved EOR Mess
A persistent glitch in Mitchell’s bill review service is causing revenue management chaos for providers. For second review appeals, providers receive electronic explanations ...
Feb 1, 2019
Sedgwick Still Reimbursing at 2018 Rates for California
Since the beginning of 2019, Sedgwick CMS has incorrectly used the 2018 Physician Fee Schedule to reimburse providers. Our data indicates that Sedgwick is consistently and in...
Feb 23, 2018
VPay Error Impacts Thousands of Sedgwick EORs
VPay, a payment processing company which issues explanation of reviews (EORs) and virtual credit card payments from claims administrators to providers, suffered a technical g...
Jan 27, 2017
Electronic EORs for Workers’ Comp: Timing and Compliance
This month, we’ve placed an emphasis on analyzing and explaining the vagaries of electronic billing for California workers’ compensation medical bills. The state’s Division o...
Oct 5, 2015
Essential Checklist for Work Comp Explanations of Review
EOR sent? Check. On time? Check. Complete information? Check.If you can’t check off all those boxes for every bill, something is wrong. Explanations of Review ...