Most Recent Articles

City of Pasadena: CompIQ Saves the Day

Following a switch to a new third-party claims administrator (TPA), the City of Pasadena violated California law by suddenly failing to accept electronic bills for the treatm...

2021 Telehealth Billing Guide for CA Workers' Comp

With COVID-19 hardly in the rearview mirror just yet, California workers’ comp providers can still utilize telehealth as a safer alternative to in-person treatment. But of co...

Disneyland Churns Out Incorrect e-Bill Rejections

Providers billing Disneyland Resorts, be warned: your electronic bills might be erroneously rejected.Recently, we reported on Disneyland Resorts’ switching its bill re...

Audit Complaint: PacificComp Fails to Process e-Bills

In California workers’ comp, a provider’s failure to adhere to the billing regulations allows the payer to refuse payment for treatment of the injured worker. But all too oft...

Alert: Sedgwick/Availity Abrupt Split May Delay e-Bill Processing

With only hours of notice, clearinghouse Availity and third-party claims administrator (TPA) Sedgwick severed their relationship. The move may catch providers and their billi...

CA Med-Legal: ML200 Missed Appointment Payable

An Independent Bill Review (IBR) case affirmed one of the biggest changes to California’s Medical-Legal Fee Schedule (MLFS): an established reimbursement for missed Medical-L...

Provider Alert: Broadspire Contorts Work First Casualty Claims

Broadspire is the designated third-party administrator (TPA) for Work First Casualty Company, a workers’ comp insurer. While Broadspire normally conducts its own internal bil...

Berkshire Hathaway Homestate Companies Switches Clearinghouse

Effective July 23, 2021, Berkshire Hathaway Homestate Companies (BHHC) switches its EDI clearinghouse, from Jopari to Carisk. The change will affect all bills sent electronic...

Disneyland Replaces Bill Review Vendor

Effective June 21, 2021, Disneyland Resorts switched its bill review vendor from Conduent to Rising Medical Solutions.The change affects all bills for all dates of ser...

Sedgwick Violates LACoFD Employer Contract, IBR Drops Ball

A physician agreed to serve as Independent Medical Examiner (IME) for the Labor Management Committee (LMC) representing the Los Angeles County Fire Department (LACoFD) and Lo...

CA Workers' Comp Q&A Highlights

We asked our readers to submit their most vital California workers’ comp questions for a live Q&A webinar. They did not disappoint!If you missed it, below is a brief r...

Sedgwick Denies Second Review Appeals as "Duplicates"

Sedgwick has a Second Review problem.On too many occasions, Sedgwick incorrectly denies providers’ Second Review appeals as “duplicate submissions” of the original bil...