Sedgwick Defies DWC COVID Rules; DWC Washes Hands
Jun 4, 2021
Sedgwick defied California workers’ comp regulations, costing a provider thousands in due reimbursement. Unfortunately, the Division of Workers’ Compensation (DWC) has declin...
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MPNs: The Jekyll and Hyde of Workers' Comp
May 20, 2021
We’ve argued that MPNs are mostly a drag on the workers’ compensation system. But as some employers demonstrate, they don’t have to be.When employers use MPNs to maint...
Anthem: PPO Discounts Result in Payments BELOW Medicare
May 19, 2021
Q: How much can a workers’ comp provider lose by signing a Preferred Provider Organization (PPO) agreement?A: Much, much more than the provider probably realizes.
How to Win Med-Legal Payment Disputes
May 17, 2021
In light of the all-new Medical-Legal Fee Schedule (MLFS) for California workers’ comp, we debuted a new tool to help providers. Our MLFS “Report Cards” analyze...
Download: Med-Legal Graphic Workflow (With Modifiers)
May 13, 2021
Effective April 1, 2021, the Division of Workers’ Compensation adopted an all-new Medical-Legal Fee Schedule, complete with new billing codes and modifiers. Like many things ...
CNA Repeatedly Ignores California Law
May 12, 2021
By law, claims administrators must remit payment for Medical-Legal services within 60 days of receiving the physician’s bill. As of this writing, payment to one physician fro...
Anthem/SCIF: MPN Kickback Scheme?
May 11, 2021
Healthcare software firm CareCloud recently agreed to a $3.8 million settlement, in part to resolve allegations that it traded unlawful payments for referrals, in violation o...
Athens Must Stop Taking Unnamed PPO Discounts
May 5, 2021
As advocates for a fair and just workers’ comp system, we here at DaisyBill feel compelled to remind insurer Athens Administrators of an important fact about California worke...
CCSF Stands Up On Behalf of Providers
May 4, 2021
Many payers delegate bill review to an outside entity, trusting the bill review vendor to properly reimburse providers. But when a provider disputes a denial or adjustment, i...
Prime Health: Unsigned Contract Tale Continues
May 3, 2021
Almost immediately after DaisyBill called out Prime Health Services (PHS) for questionable PPO practices, it was clear we struck a nerve. PHS attorneys sent DaisyBill a ‘plea...
Introducing: CA Med-Legal Fee Schedule Report Cards
Apr 29, 2021
At DaisyBill, we strive to help providers and their staff navigate the complexities of workers’ comp billing and payment, to ensure proper reimbursement. To that end, we’re d...
California MPNs: Camouflage for Discounts and Denials
Apr 27, 2021
Medical Provider Networks (MPNs) are under fire — as they should be.Far too often, Calforina claims administrators (aka ‘payers’) use MPNs — and providers’ unfamiliari...