Most Recent Articles
Sedgwick Denying Bills with Incorrect Adjustment Reason Codes
Apr 29, 2014
Sedgwick Denying Bills with Incorrect Adjustment Reason Codes
Claims Administrator: Sedgwick Claims Management ServicesIssue: Inaccurate Adjustment Reason Codes contained in Sedgwick’s EOR denialsStatus
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Apr 28, 2014
Changes to OMFS: Pharmaceutical, DMEPOS, and Physician Fee Schedule
The DWC passed major changes to the workers’ compensation fee schedules, affecting reimbursements for pharmaceutical NDC numbers, DMEPOS, and splinting and casting Q codes.  ...
Liberty Mutual Incorrectly Denying Bills Using Explain Code B649
Apr 28, 2014
Liberty Mutual Incorrectly Denying Bills Using Explain Code B649
Claims Administrator:  Liberty MutualIssue:  Incorrect denial of billsStatus:  OpenDescription: Recently, claims administrato...
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Apr 28, 2014
How Electronic Billing Works, Part II
Last time, we covered: What happens after providers hit "send" when transmitting electronic bills Why electronic bills get denied This time we discuss wh...
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Apr 25, 2014
More Workers' Comp Fee Schedule Changes
The DWC passed changes to the workers’ comp fee schedules, affecting:Pathology and clinical laboratory feesRelative Value FileCCI EditsMedi-Cal Ph...
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Apr 24, 2014
How Electronic Billing Works, Part I
If you’ve ever sent an email, you already have a general understanding of how workers’ compensation electronic billing works.  So we’re going to use what you already know abo...
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Apr 23, 2014
New CMS 1500 Form
Starting April 1, 2014, providers in California must use a new CMS 1500 form when submitting bills for treatment provided to injured workers.  The transition period has come ...
Electronic Billing Timelines
Apr 22, 2014
Electronic Billing Timelines
One of the greatest benefits of electronic billing for workers compensation is how much it speeds up the whole process. In addition, work comp e-billing helps with making sur...
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Apr 19, 2014
Electronic Billing in a Nutshell
THE LAWThe electronic billing mandate is a statute that's in the Labor Code, as Title 8 of CCR: Sections 9792.5.1(b), 9792.5.2(c) and 9792.5.3(b).In effect sinc...
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Apr 16, 2014
The Benefits of Acknowledgement Protocols
For workers' comp medical e-bills, acknowledgement protocols are designed to catch the following billing errors before review by a claims administrator: e-Bills submit...
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Apr 15, 2014
Electronic Billing Compliance for Claims Administrators
In California, electronic billing has been mandated for workers compensation medical bills since October 18th, 2012.  For claims administrators, this means that you mu...
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Feb 26, 2014
California Specific Work Comp Codes
As providers still billing on paper begin to receive payments for their January 2014 dates of service, we’re receiving inquiries about the California specific codes that beca...