Most Recent Articles

CA OMFS: Physician Fee Schedule Update Effective April 1

California’s Division of Workers’ Compensation (DWC) issued an update to the Physician and Non-Physician Practitioner portion of the Official Medical Fee Schedule (OMFS) for ...

Zurich Delays Telehealth Reimbursement During Pandemic

Zurich seems committed to a policy of improperly denying reimbursement for telehealth services, during a pandemic in which remote treatment is crucial to maintaining care for...

Travelers, SCIF Incorrectly Apply New E/M Rules Before Effective Dates

Every year, we see claims administrators incorrectly deny reimbursement because they fail to keep up with the latest changes to the Official Medical Fee Schedule (OMFS). But ...

IBR Hall of Shame: Employers

Employers Holdings set a shameful new standard of indifference with regard to promptly and correctly reimbursing providers. The insurer incorrectly denied payment, disregarde...

How To Stop A Network From Taking Your Revenue

Recently, a DaisyBill provider contacted us to discuss a disturbing network contract, one that expands its net well beyond what this provider initially believed...

How to Apply HCPCS G2212 in CA Workers' Comp

Important Update: The DWC adopted an MUE limiting the number of units of G2212 providers may bill. Details below!This year, California’s Division of Workers’ Compensat...

Gallagher Bassett, Foster Farms Lay A Rotten Egg in CA

Update: As of April 1, 2021 Gallagher Bassett can locate and process claims for Foster Farms employees. Workers’ compensation claims for injured employees of Foster Fa...

2021 Facility E/M Reimbursement Rates for CA Workers' Comp

Evaluation and Management (E/M) billing is very different for California workers’ comp physicians in 2021. Among the changes to the Physician Fee Schedule are new reim...

2021 E/M Reimbursement Rates for CA Workers' Comp

As we reported previously, California’s Division of Workers’ Compensation made major changes to Evaluation and Management (E/M) billing for 2021. In addition to updati...

CA OMFS: E/M Billing - 2021 Major Changes

Effective March 1, updates to California’s Physician and Non-Physician Practitioner Fee Schedule significantly alter the way providers bill for Evaluation and Management (E/M...

ESIS + Conduent + StrataCare = Provider Torment

Preferred Provider Organizations (PPOs) profit from reducing the reimbursements providers receive for treating injured workers. Yet, we would argue that providers (and injure...

Warning: Do Not Accept Credit Cards as Payment

In the past we have written a number of posts (including one about Broadspire) warning providers to not accept credit card payments issued by payers such as claims administra...