York (aka Sedgwick) Fails Math: EORs Literally Don't Add Up
Sep 19, 2019
York Risk Services, which was acquired this month by Sedgwick, has significant math troubles. York recently returned Explanations of Review (EORs) which obfuscated the effect...
Fresno USD Fails to Comply with Electronic Billing Regulations
Sep 17, 2019
For providers treating injured workers, electronic billing is by far the best billing option. For claims administrators in California, it’s not optional at all; accepting ele...
San Francisco MTA Switches Bill Review
Sep 12, 2019
San Francisco Municipal Transportation Agency (SFMTA) switched bill review services, from Mitchell to EK Health.The change is effective August 29, and affects bills fo...
IBR Stats Show Why Fighting Incorrect Reimbursement Is Worth It
Sep 6, 2019
In California, it can be entirely too difficult for providers to collect proper reimbursement for treating injured workers. Among the many reasons for this unfortunate realit...
Claims Admins EXPLOIT Lack of Regulations in Timely Filing Law
Sep 5, 2019
In 2016, California State Bill 1160 was signed into law, instituting new timely filing requirements for workers’ comp medical treatment bills. Since 2017, Labor Code Section ...
Liberty Mutual, Gallagher Bassett, Chubb Scoff at CA IBR Rules
Sep 4, 2019
It’s still happening: claims administrators including Liberty Mutual, Gallagher Bassett, and Chubb are ignoring the rules regarding Independent Bill Review (IBR), brazenly re...
Technical Difficulties Trouble San Diego Bill Review Switch
Aug 26, 2019
The City of San Diego, a self-insured, self-administered California employer, is in the process of switching bill review services from Genex to Medata. The transition, though...
South San Francisco, Marin County Change TPAs
Aug 23, 2019
Two municipal employers in California switched third-party administrators (TPAs). Both the City of South San Francisco and the County of Marin transferred claims from TriStar...
SCIF, CorVel IBR Withdrawal Requests Create ENORMOUS Hassles for Providers
Aug 16, 2019
The billing lesson for today: providers should never agree to withdraw a request for Independent Bill Review (IBR), no matter how sweetly the payor begs. Trust us; we’ve lear...
Select Staffing: Changes TPA and Claim Numbers
Aug 15, 2019
Attention California providers: Select Staffing no longer uses CorVel as its Third-Party Administrator (TPA).Effective July 1, 2019, Broadspire administers all claims ...
NonCompliant CNA, Crum & Forster, County of San Diego - Electronic EORs Not Optional
Aug 8, 2019
As California continues its transition to fully paperless workers’ comp billing and payment, some claims administrators have apparently decided to follow their own regulation...
Blatant Disregard for IBR Law by Sedgwick, Gallagher, Athens, Helmsman
Aug 5, 2019
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...