Most Recent Articles

Blatant Disregard for IBR Law by Sedgwick, Gallagher, Athens, Helmsman

A disturbing pattern is emerging from the results of Independent Bill Review (IBR) decisions in the state of California. As usual, the problem encumbers workers’ comp provide...

Berkshire Hathaway Fails to Process Second Review Appeals

Berkshire Hathaway Homestate Companies (BHHC) is failing to process electronic second review appeals, leaving providers in an unacceptable payment limbo. The insurer incorrec...

CorVel Crash: Security Breach Leads to System-Wide Shutdown

A security incident led workers’ comp claims administrator CorVel to shut down systems nationwide last week, prompting credible rumors of a ransomware attack. As of th...

Costco, Home Depot, & Other Employers Should Be Mad as HEL*

Recently a provider shared a letter, apparently meant to intimidate, that it received from a Liberty Mutual Network Specialist, Peter Spalding. The letter threatened to kick ...

Mitchell Unresolved EOR Mess

A persistent glitch in Mitchell’s bill review service is causing revenue management chaos for providers. For second review appeals, providers receive electronic explanations ...

TPA Alert: LA County Switches Claims Administrators

Effective July 1, 2019, the County of Los Angeles is no longer utilizing third-party claims administrator (TPA) TriStar Risk Management. Claims are transferred to eith...

CA OMFS: DMEPOS Fee Schedule Update Effective 7/1/2019

In Newsline No.: 2019-53, the California Division of Workers’ Compensation (DWC) announced updates to the Official Medical Fee Schedule for Durable Medical Equipment, Prosthe...

CA OMFS Update: Pathology/Clinical Lab Fee Schedule for 7/1/2019

On July 8, 2019, California’s Division of Workers’ Compensation (DWC) ordered an update to the Pathology and Clinical Laboratory section of the Official Medical Fee Schedule ...

Magna Carta - Bills Not Processed

Providers, be aware that Magna Carta Companies (formerly PSM) ended its relationship with its bill review service, CorVel. More importantly, Magna Carta is not responding to ...

Claims Admins Deny Second Review Appeals as Duplicate Bills

Two claims administrators, York and Sedgwick, denied hundreds of compliant second review appeals on the grounds that the appeals were “duplicates” of the Original Bills in qu...

Virginia Workers' Comp Enters New Century

The Virginia Workers' Compensation Commission (VWCC), in its hundredth year of operation, will enter the 21st century as of next week. Effective July 1, 2019, the VWCC...

CA Physician MUE Reimbursement Change as of 7/1/2019

In Newsline No.: 2019-46, the California Division of Workers’ Comp (DWC) announced changes to the Official Medical Fee Schedule for Physician Services / Non-Physician Practit...