Most Recent Articles
Oct 17, 2023
CA DWC Fails to Support Injured Workers' Rights Under MPNs
When a California employee sustains a work-related injury, and the employer maintains a Medical Provider Network (MPN), it is the employer’s legal responsibility to (within o...
Oct 11, 2023
"Not on File": How to Get e-Billing Right
Howworkers’ compe-billing should work: you submit bills (and medical documents) with a few clicks. Payments arrive quickly, and your e-billing software a...
Oct 10, 2023
PPO: Why Your Practice Should Renegotiate (or Cancel) Discount Contracts
Preferred Provider Organizations (PPOs) are choking the financial life out of providers who treat injured workers. This problem is being reported by doctors throughout...
Oct 6, 2023
CA OMFS Update: Physician Services (Q4 2023)
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 ...
Oct 5, 2023
SCIF Inept UR #8: EK Health Makes False MTUS Claim
State Compensation Insurance Fund (SCIF) and EK Healthjust can’t seem to get the hang of Utilization Review (UR).We previousl...
Oct 4, 2023
Obituary: Major CA Practice Quits Workers' Comp Treatment
RIP RehabOne Medical Group, 2004-2023California workers’ comp will lose a pillar of the provider community, effective at the close of this year. RehabOne will have pro...
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Oct 3, 2023
SCIF Inept UR #7: Truly Unbelievable Incompetence
Employees, taxpayers, and moral human beings should be outraged by Utilization Review (UR) abuse inflicted on a state employee by the State Compensation Insurance Fund (SCIF)...
Oct 2, 2023
SCIF, EK Health Use "ODG" Guidelines to Deny Care
For injured California workers, simply getting the appropriate care can be a nightmare of bureaucratic obstacles and interminable delays. An additional complication ha...
Sep 29, 2023
SCIF Inept UR #6: Non-MTUS Guidelines Strike Again
Once again, State Compensation Insurance Fund (SCIF) and EK Health denied surgery for an injured worker by citing unadopted, alternative treatment guidelines outside of Calif...
Sep 28, 2023
Berkshire Hathaway: 10,735 Audit Complaints Filed With CA DWC
Berkshire Hathaway Homestate Companies (BHHC) is backsliding into old, bad habits.Over the summer, BHHC failed to send thousands of electronic Explanations of Review (...
Sep 27, 2023
SCIF Inept UR #5: EK Health Ignores MTUS, Denies Surgery
Why is it so difficult to get treatment for a work-related injury? At least in California, most of the answer is a broken UR system that allows insurers to withhold potential...
Sep 26, 2023
ProPublica/NPR: Fees & Discounts Gutting Provider Revenue
ProPublica and NPR recently published an exposé on entities that impose fees on doctors who accept electronic funds transfer (EFT) payments. These fees c...