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Sedgwick Late e-EORs: 13,999 Audit Complaints Submitted
Jun 23, 2022
Sedgwick Late e-EORs: 13,999 Audit Complaints Submitted
Sedgwick Claims Management Services is breaking the law. We encourage the California Division of Workers’ Compensation (DWC) to assert its role in upholding workers’ comp law...
CA: Employer Authorization Is Ultimately Worthless
Jun 23, 2022
CA: Employer Authorization Is Ultimately Worthless
California law mandates that once an employer authorizes treatment for an injured worker, that authorization may not be rescinded “for any reason,” theoretically guaranteeing...
Sedgwick: Gruesome and Abusive IBR Games
Jun 15, 2022
Sedgwick: Gruesome and Abusive IBR Games
In California workers’ comp, providers cannot rely on authorization to guarantee payment — despite what the law says. Today’s article shows exactly how a claims administrator...
CA OMFS: E/M Reimbursement vs Medicare Reimbursement
Jun 8, 2022
CA OMFS: E/M Reimbursement vs Medicare Reimbursement
California workers’ comp allows discount networks to bleed the doctors who treat injured workers. Unfortunately for these workers and their employers, many of these financial...
Hurray! Proposed IBR Changes Benefit Doctors
Jun 8, 2022
Hurray! Proposed IBR Changes Benefit Doctors
Proposed legislation in California would allow the state’s Independent Bill Review (IBR) organization (Maximus) to invoice the payer (aka claims administrator) for the review...
New! Penalty & Interest Added to Claims Admin Directory
Jun 8, 2022
New! Penalty & Interest Added to Claims Admin Directory
Penalties and interest for untimely paid workers’ comp bills are not well-enforced in California — but daisyBill is keeping score.Our free Claims Administrator Directo...
Broadspire Sends Ludicrous Refund Demand to Doctor
Jun 2, 2022
Broadspire Sends Ludicrous Refund Demand to Doctor
You’ll have to read it to believe it. Third-Party Administrator (TPA) Broadspire sent a perfectly ludicrous letter to a doctor, demanding the doctor refund Broadspire ...
Data: e-EOR Compliance Rates
Jun 1, 2022
Data: e-EOR Compliance Rates
To facilitate electronic billing for workers’ comp, California requires all claims administrators to respond to provider e-bills with electronic EORs (e-EORs). Within 15 work...
Data: e-Bill 277 Acknowledgement Compliance Rates
Jun 1, 2022
Data: e-Bill 277 Acknowledgement Compliance Rates
To facilitate electronic billing for workers’ comp, California requires claims administrators to confirm receipt of provider e-bills with a standardized electronic acknowledg...
Major e-Bill Failure for Data Dimensions Clients
May 25, 2022
Major e-Bill Failure for Data Dimensions Clients
One hundred claims administrators, all of which use Data Dimensions as their designated clearinghouse, are suddenly failing to comply with California e-billing requirements. ...
Alert: ESIS Fails to Process e-Bills Due to (Their) Document Error
May 19, 2022
Alert: ESIS Fails to Process e-Bills Due to (Their) Document Error
A daisyBill provider client recently brought to our attention systemic e-billing non-compliance by Third-Party Administrator (TPA) ESIS, Inc. Specifically, ESIS denied paymen...
Sedgwick Resolves LA County Missing e-EORs
May 18, 2022
Sedgwick Resolves LA County Missing e-EORs
daisyBill contacted Sedgwick regarding e-bills for treatment rendered to employees of the County of Los Angeles (claims beginning with 5000 or ending in D), for...