Most Recent Articles
Feb 21, 2023
CPT 99358 & 99359: Error Corrected
With apologies for any confusion, we offer the following correction.Our February 13 2023 article, clarifying that billing codes CPT 99358 and CPT 99359 remain payable ...
Feb 15, 2023
Data: CA UR Decisions 2022
One of the great sources of friction in California workers’ comp is the Utilization Review (UR) and treatment authorization process — the critical process that determines whe...
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Feb 14, 2023
2023 CA Physician Fee Schedule Changes
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 ...
Feb 9, 2023
E/M Data: CPT 99214 Reimbursement 2022
Far too often, California providers are not receiving Official Medical Fee Schedule (OMFS) rates for Evaluation and Management (E/M) for injured workers — as evidenced by our...
Feb 8, 2023
Data: SCIF Pays Medicare Rates for E/M Services
Like The Zenith, California’s State Compensation Insurance Fund (SCIF) consistently pays Medicare rates to doctors for treating injured workers.According to data from ...
Feb 7, 2023
Data: Zenith Pays Medicare Rates for E/M Services
According to data from over 10,000 e-bills submitted for 2022 dates of service via daisyBill, insurer The Zenith paid 76% of the reimbursement rates established by California...
Feb 6, 2023
Anthem PPO Contract Renders OMFS Meaningless
At first glance, recent updates to California’s Official Medical Fee Schedule (OMFS) for workers’ comp may seem like a raise for doctors. By establishing OMFS rates at roughl...
Feb 1, 2023
CA 2022 Data: Claims Admin Days to Payment
The numbers are in! 2022 data prove once again that electronic billing slashes the time it takes for providers to get paid for treating injured workers in California (...
Jan 31, 2023
CA Physician Fee Schedule - 2023 Changes
Yesterday, California’s Division of Workers’ Compensation (DWC) announced reimbursement updates to the Physician and Non-Physician Practitioner Services section...
Jan 30, 2023
Med-Legal IBR Data: A Bad Look for Sedgwick & CA
California appears to turn a willfully blind eye to what seems like an abuse of the Independent Bill Review (IBR) system for Medical-Legal disputes.Data ...
Jan 26, 2023
Forbes Fluff Distorts CA Workers' Comp Realities
The good folks at Forbes recently offered California doctors and injured workers a slap in the face, in the form of a political fantasy narrative thinly veiled as an objectiv...
Jan 24, 2023
CA e-EOR Compliance: 2022 Report Card
Not everything in California workers’ comp is complicated. For example: when a provider chooses to bill electronically for medical services, California regulations req...