Most Recent Articles
Mar 15, 2018
Outpatient/ASC Fee Schedule: DWC Issues (Then Corrects) Reimbursements
The California Division of Workers’ Compensation (DWC) ordered new adjustments to the Official Medical Fee Schedule (OMFS), effective March 15, 2018. The orders update fees f...
Mar 13, 2018
How Workers’ Comp Payments By Credit Card Hurt CA Providers
Accepting credit cards from patients for co-pays and deductibles is one thing, but it makes zero financial sense for California providers to accept credit card payments from ...
Mar 9, 2018
Complete 2018 Automatic Authorization Guide for California Workers’ Comp
Over the last several months, we blogged extensively (and hosted a free comprehensive webinar) on the new automatic authorization process for California workers’ comp. Here, ...
Mar 6, 2018
Discount Dangers: The Provider’s Bill of Rights (Rights III and IV)
Discount Dangers is a DaisyBill series on the ways discount contracts incorrectly reduce providers’ reimbursements. With this series, we shine a light on the worst discount p...
Mar 5, 2018
CPT 97750 for Functional Capacity Exams: Medically Unlikely Edits
Providers sometimes run into trouble when billing Current Procedural Terminology (CPT) Code 97750. Providers use this procedure code to bill for functional capacity exams, in...
Mar 2, 2018
FYI: $10k of Treatment Authorized Before Claim is Accepted or Denied
When an employee files a workers’ compensation claim, the employer or insurer is immediately liable for the cost of all medically necessary treatment provided before the clai...
Mar 1, 2018
When is it Appropriate to File a Lien?
A second review appeal isn’t always enough. Sometimes, providers must take further action to secure proper reimbursement.When a second review appeal fails to produce t...
Feb 28, 2018
Primary Treating Physicians: Keep Your PR-2 Reports on Point!
If you’re the primary treating physician (PTP) for an injured worker, you already know the Treating Physician’s Progress Report (on Form PR-2 or the narrative equivalent ther...
Feb 23, 2018
VPay Error Impacts Thousands of Sedgwick EORs
VPay, a payment processing company which issues explanation of reviews (EORs) and virtual credit card payments from claims administrators to providers, suffered a technical g...
Feb 21, 2018
Reminder: E/M Reimbursements Higher in 2018
*Update: The 2021 OMFS updates drastically changed how E/M codes are billed.*Some of the most commonly used billing codes by our providers, Evaluation an...
Feb 16, 2018
Authorization/Utilization Review: Why Peer-to-Peer Calls Are a Bad Idea
There’s been lots to say about authorization and utilization review (UR) this year, especially given the major changes to the process. However, one UR rule that remains the s...
Feb 15, 2018
How to Bill for Physician-Dispensed Pharmaceuticals
Payments for physician-dispensed drugs are some of the most misunderstood — and incorrectly denied — in workers’ compensation billing. Too often, the employer or insurer’s cl...