Most Recent Articles

Gallagher Bassett, Foster Farms Lay A Rotten Egg in CA

Update: As of April 1, 2021 Gallagher Bassett can locate and process claims for Foster Farms employees. Workers’ compensation claims for injured employees of Foster Fa...

2021 Facility E/M Reimbursement Rates for CA Workers' Comp

Evaluation and Management (E/M) billing is very different for California workers’ comp physicians in 2021. Among the changes to the Physician Fee Schedule are new reim...

2021 E/M Reimbursement Rates for CA Workers' Comp

As we reported previously, California’s Division of Workers’ Compensation made major changes to Evaluation and Management (E/M) billing for 2021. In addition to updati...

CA OMFS: E/M Billing - 2021 Major Changes

Effective March 1, updates to California’s Physician and Non-Physician Practitioner Fee Schedule significantly alter the way providers bill for Evaluation and Management (E/M...

ESIS + Conduent + StrataCare = Provider Torment

Preferred Provider Organizations (PPOs) profit from reducing the reimbursements providers receive for treating injured workers. Yet, we would argue that providers (and injure...

Warning: Do Not Accept Credit Cards as Payment

In the past we have written a number of posts (including one about Broadspire) warning providers to not accept credit card payments issued by payers such as claims administra...

Sedgwick & Mitchell Setting Up a Legal Protection Racket?

Sedgwick, in cahoots with Mitchell, seems to be setting up some kind of protection racket where, in exchange for providers accepting lower reimbursement, Sedgwick/Mitchell wi...

CA OMFS - Reimbursements Reduced for Physician Services

Yesterday, the California Division of Workers’ Compensation (DWC) announced the 2021 reimbursement changes to the Physician Services section of the Official Medical Fee Sched...

Payer Refuses to Send Electronic EORs Despite Clear Law

The California law regarding electronic explanations of review (EORs) is crystal clear and completely unambiguous -- at least to the vast majority of the workers’ comp commun...

Fresno USD Fails to Comply with Electronic Billing Regulations

For providers treating injured workers, electronic billing is by far the best billing option. For claims administrators in California, it’s not optional at all; accepting ele...

ESIS & ABM Industries - IBR Hall of Shame

We continue to look at the misbehavior of ESIS, which yesterday entered the IBR Hall of Shame for its deplorable treatment of a provider who prevailed in two Independent Bill...

Is ESIS Gaming California's Work Comp System?

In this latest installment of the IBR Hall of Shame, we chronicle the never-ending payment torture inflicted on a provider who “wins” an Independent Bill Review (IBR). This i...