Most Recent Articles

Sedgwick Erroneously Rejects Provider Bills

Workers’ comp providers, be aware: insurer Sedgwick has recently incorrectly rejected multiple bills on erroneous grounds, necessitating that time and resources be spent inve...

CA State Report: QMEs Deserve Better From DWC

A report from a California State Auditor found much to be desired regarding the Division of Workers' Compensation (DWC)'s handling of Qualified Medical Evaluators.Elai...

California-Specific Codes - 2020 Reimbursement Updates

Attention California providers -- in 2020 reimbursements increased for all California-specific workers’ comp codes!In the Physician Fee Schedule, these state-specific ...

CPTs 99358 & 99359 - 2020 CA Reimbursement Cheat Sheet

Changes have been made to the California OMFS since the publication of this article. Be sure to see the latest analyses here and here.2021 OMFS updates drastically cha...

Alert: DWC Retroactively Updates CA OMFS

Last Thursday, January 30, 2020, the California Division of Workers’ Comp (DWC) released a retroactive change to the 2020 Physician Fee Schedule. Announced in Newsline #2020-...

Sedgwick – IBR Hall of Shame

All too often, insurance companies and claims administrators find unfair ways to deny, delay, and otherwise wiggle out of paying the workers’ compensation reimbursements that...

2020 CA Workers’ Comp E/M Cheat Sheet

Hooray! In 2020 reimbursements increased across the board for Evaluation & Management (E&M) codes!Below we’ve compiled a nifty reimbursement cheat sheet for the seven ...

STRONG WARNING! Travelers Refuses to Pay Provider

We advise providers to think carefully before treating injured workers covered by Travelers. Below, we summarize the nightmarish run-around that an MPN provider experienced w...

CA Interpreters: No Second Review = No Payment

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

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

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?

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...