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An Open Letter to Sedgwick Claims Management Services, Inc.
Sep 26, 2022
An Open Letter to Sedgwick Claims Management Services, Inc.

Dear Sedgwick Claims Management Services,

This is a plea.

In all sincerity, and all snark aside, California workers, providers, and employers need you to do better.

As one of the nation’s largest claims administrators (and by far the largest recipient of bills from daisyBill), you have an unmatched capacity to improve or degrade the entire workers' comp system — and we ask you to choose the former.

Our data demonstrate your systemic, wide-scale failure to adhere to California workers’ comp payment laws and regulations. Over the last 8 months, you failed to return electronic Explanations of Review (e-EORs) for over 44,000 e-bills sent to you by providers for the treatment of injured workers. This non-compliance means you either:

  1. Failed to pay 23% of the e-bills sent to Sedgwick, or
  2. Snail-mailed paper EORs (in violation of state regulations), forcing providers to expend unwarranted time and administrative resources to compensate for your non-compliance.

It’s a sad cliche: injured workers struggle to find care, because many doctors won’t treat workers’ comp patients. Reportedly, this is because doctors believe they can’t get paid for treating injured workers. And when they do get paid, it’s only after navigating an incredible amount of hassle.

Sadly, your non-compliant response to over 44,000 e-bills makes the cliche a truism — and it’s within your power to change it.

Read More
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