CNA Repeatedly Ignores California Law
May 12, 2021
By law, claims administrators must remit payment for Medical-Legal services within 60 days of receiving the physician’s bill. As of this writing, payment to one physician fro...
Anthem/SCIF: MPN Kickback Scheme?
May 11, 2021
Healthcare software firm CareCloud recently agreed to a $3.8 million settlement, in part to resolve allegations that it traded unlawful payments for referrals, in violation o...
Athens Must Stop Taking Unnamed PPO Discounts
May 5, 2021
As advocates for a fair and just workers’ comp system, we here at DaisyBill feel compelled to remind insurer Athens Administrators of an important fact about California worke...
CCSF Stands Up On Behalf of Providers
May 4, 2021
Many payers delegate bill review to an outside entity, trusting the bill review vendor to properly reimburse providers. But when a provider disputes a denial or adjustment, i...
ML201 - Barrett Business Services Inc.: Grade A
May 3, 2021
Claims administrator properly processed reimbursement for ML201. Date of Service: 04/09/2021
ML200 - AmTrust North America: Grade F
May 3, 2021
Claims administrator failed to properly reimburse ML200. AmTrust incorrectly re-coded ML200 to ML100. Date of Service: 04/02/2021
Prime Health: Unsigned Contract Tale Continues
May 3, 2021
Almost immediately after DaisyBill called out Prime Health Services (PHS) for questionable PPO practices, it was clear we struck a nerve. PHS attorneys sent DaisyBill a ‘plea...
ML200 - Mitsui Sumitomo Insurance: Grade A
May 3, 2021
Claims administrator properly processed reimbursement for ML200. Date of Service: 04/02/2021
ML200 - Sedgwick Claims Management Services: Grade F
May 3, 2021
Claims administrator failed to properly reimburse ML200. Sedgwick incorrectly denied valid medical-legal code as “not considered a valid reimbursable code.” Date of Service: ...
ML200 - Benchmark Insurance Company: Grade A
May 3, 2021
Claims administrator properly processed reimbursement for ML200. Date of Service: 04/02/2021
ML200 - Sedgwick Claims Management Services: Grade F
May 3, 2021
Claims administrator failed to properly reimburse ML200. Sedgwick incorrectly denied valid medical-legal code as “not considered a valid reimbursable code.” Date of Service: ...