Most Recent Articles

$47 Million and Counting: Second Review Saves Provider Revenue

California workers’ comp providers face an inexcusable amount of hassle, red tape, and outright abuse in the struggle to collect correct reimbursement. Take it from us...

California IBR Fee Reduced Effective January 2020

Finally, some good news about Independent Bill Review (IBR)! Effective January 1, 2020, the required filing fee for providers requesting IBR dropped from $195 to $180.

CorVel Disguises PPO Discounts

We’ve raised the alarm about Preferred Provider Organization (PPO) and Network discount contracts before. Supposedly, in exchange for more patients, these PPO and Network con...

Benihana AND Broadspire Join IBR Hall of Shame

In this entry in the IBR Hall of Shame, we surface still another example of a workers’ comp claims administrator clearly not understanding, or not complying with, and/or just...

California - 3 Workers' Comp Authorization Myths, Debunked

Providers who treat injured workers have one simple, reasonable request: correct reimbursement. In helping providers to obtain correct reimbursement, we answer a daily...

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 ...