CA Interpreters: No Second Review = No Payment
Dec 2, 2019
Providers — interpreters in particular — be advised: a California appeals court ruled that claims administrator Meadowbrook Insurance is not required to pay a disputed fee fo...
Sally Beauty Holdings: Changes TPA and Claim Numbers
Nov 26, 2019
Sally Beauty Holdings no longer uses CorVel as its third-party administrator (TPA).Effective November 15, 2019, Broadspire administers all claims for Sally Beauty Hold...
SCIF Tantrum Subverts the IBR Process
Nov 25, 2019
Few behaviors induce more cynicism than when claims administrators ask providers to withdraw requests for Independent Bill Review (IBR) in exchange for correct payment. Appar...
Hanover –> What the H*llover is Going On?
Nov 21, 2019
We have yet another tale of a payer flagrantly ignoring its duty to compliantly process provider bills for treatment of injured workers. This account of payer friction highli...
CPT 99358 - Maximus Correctly Rules in Favor of Provider (Hurray!)
Nov 18, 2019
In the past, DaisyBill has reported on many, many problems with Maximus Independent Bill Review (IBR) decisions for CPT code 99358. Today, we happily report that Maximus is n...
City of Los Angeles Neglects Its Duty
Nov 14, 2019
The City of Los Angeles (LA) is a self-insured, self-administered employer. This means that the city assumes all of the responsibilities of a claims administrator to complian...
Markel First/Midwest EORs Leave Providers in the Dark
Nov 12, 2019
Electronic Explanations of Review (EORs) from Markel First and Midwest Insurance are missing crucial pieces of information. Key required elements like patient names and Socia...
Liberty Mutual Sued by Employer
Nov 6, 2019
According to a federal lawsuit filed in October, Liberty Mutual Insurance may be playing its workers’ comp cards a little too close to the chest.The lawsuit, Valley Co...
Convoluted Coding: Applied Underwriters Tries to Shortchange Provider
Nov 4, 2019
For anyone concerned by the lack of providers willing to treat injured workers, the following dark tale perfectly illustrates the reason so many providers flee workers’ comp....
Bill Review Highlight: Definiti Healthcare Management
Nov 3, 2019
Over the last several years, providers have sent over 5.2 million workers’ comp bills from DaisyBill. These millions of bills allow DaisyBill to directly witness the manageme...
Maximus & DWC Drop Ball on IBR Eligibility
Oct 22, 2019
California workers’ comp billing and payment regulations are a minefield of complications. That said, some rules are fairly simple, and should be immutable. For exampl...