Most Recent Articles

Med-Legal Reports: Always Include Page Count Verification!

California’s new Medical-Legal Fee Schedule (MLFS), effective from April 2021, brought with it new rules for reporting, billing, and payment. Among those rules: when submitti...

SCIF Hacks IBR by Switching (Incorrect) Denial Reason

There’s a serious inequity in the appeals process by which California workers’ comp providers can dispute incorrect reimbursement for authorized treatment. State Compensation...

A Doctor's Warning: PPOs "Helped Close Our Doors"

Recently we received an email from a retired California doctor. This doctor, after 35 years treating injured workers, was unable to sell his practice — because no other provi...

Data: Drastic PPO Discounts Revealed

It’s time to reveal what’s really harming injured workers in California. Starting today, DaisyBill will publicize the reduced reimbursement rates foisted on our provid...

AIG: Improper (but Logical) Med-Legal Underpayment

AIG improperly reduced a California Medical-Legal bill by 88%, providing a dramatic example of how California law incentivizes payers to incorrectly reimburse physicians who ...

ESIS Fails to Pay IBR Fee on Behalf of ABM Industries

Ask yourself — what happens if you’re a year late paying a bill?Your credit score tanks? Your car is repossessed? Your home foreclosed on? In most walks of life...

CA Cheat Sheet: Required Reports & Supporting Documentation for Workers' Comp Bills

In California, when submitting a bill for treating an injured worker, it’s imperative to include the correct documentation to support the treatment. If the provider fails to ...

Med-Legal Diagnostic Testing Is Reimbursable

FAQ: Is diagnostic testing, as part of a Medical-Legal evaluation, separately reimbursable?A: Yes, as long as the testing is necessary to complete the evaluation.<...

Med-Legal Reports: Always Include Page Count Verification!

Preferred Provider Organization (PPO) and other network discounts do not apply to the Medical-Legal Fee Schedule (MLFS). Period.In other words, the MLFS and OMFS are c...

WorkCompEDI Acquired by Data Dimensions

WorkCompEDI (WCEDI) has a new owner. The clearinghouse, which processes millions of provider electronic bills annually, was acquired by Data Dimensions, an automation ...

Med-Legal ML106: IBRs Leave No Doubt

If it wasn’t clear before, it certainly is now. Physicians should bill for supplemental Medical-Legal reports requested before April 1, 2021 with billing code ML106, regardle...

Sedgwick: Sketchy EOR Math for LA Unified School District

Sedgwick recently returned an Explanation of Review (EOR) that failed to fulfill a crucial requirement: showing how Sedgwick actually calculated the reimbursement amount paid...