Yesterday daisyNews reported on a California provider inexplicably receiving three large checks from Preferred Provider Organization (PPO) Careworks, purporting to bulk-pay 199 bills on behalf of multiple claims administrators. Today, we expand on that report by listing the employers whose funds Careworks used to issue these payments. We also take this opportunity to correct an error from the original post.
According to the paper Explanations of Review (EORs), Careworks applied payment reductions based on the provider’s alleged contract with Fast360. However, the provider has no contract with either Careworks or Fast360, meaning no contractual relationship exists that would justify those reductions.
Making matters worse, every single payment failed to comply with California workers’ comp laws and regulations:
Below, we list the employers whose injured workers’ bills were paid (and discounted) in this confusing and non-compliant manner.
Correction:
In the previous blog article, daisyNews incorrectly cited California Insurance Code §2509.1(d) as prohibiting the commingling of client claims funds. That citation was inaccurate, and no current law expressly bans entities in the workers’ comp space from pooling funds across clients. While such practices may raise transparency concerns, there is no specific legal prohibition. We’ve updated the blog to reflect this and appreciate your understanding.
Employer Alert: Your workers’ compensation dollars are being inexplicably transferred to a third-party entity (owned by Sedgwick) to distribute to doctors treating injured workers.
Claims Administrator |
Employer |
Bill Count |
Payment Amount |
AmeriTrust Group, Inc. |
Cal Enterprise Labor Solutions |
1 |
$147 |
Kern Harvesting, Inc |
1 |
$201 |
|
Trophy Automotive Dealer Group |
1 |
$147 |
|
AmeriTrust Group, Inc. Total |
3 |
$496 |
|
National Interstate Insurance |
Storer Transportation |
1 |
$127 |
Student Transportation Of America |
1 |
$276 |
|
Thompson & Harvey Bay Area, LLC |
2 |
$306 |
|
National Interstate Insurance Total |
4 |
$709 |
|
QBE North American |
Blue City Holdings, LLC |
1 |
$610 |
Green 16, LLC |
1 |
$147 |
|
Idg Holdco, LLC |
1 |
$201 |
|
Msx International, LLC |
1 |
$147 |
|
Tower Wav, LLC |
1 |
$201 |
|
QBE North American Total |
5 |
$1,307 |
|
Sedgwick Claims Management Services, Inc. |
7-Eleven |
1 |
$147 |
ABM Industries |
4 |
$771 |
|
AHGL-Adventist Health Glendale |
5 |
$898 |
|
AHSV-Adventures Health Simi Valley |
1 |
$147 |
|
AHWM- Adventist Health White Memorial |
1 |
$14 |
|
Albertson's |
1 |
$147 |
|
Amazon.com, Inc. |
13 |
$2,618 |
|
Anheuser-Busch, Incorporated |
4 |
$771 |
|
Archdiocese Of Los Angeles |
2 |
$476 |
|
ASCIP |
1 |
$201 |
|
AT&T Services, Inc |
6 |
$1,045 |
|
Avelo Airlines, Inc |
1 |
$263 |
|
Avibank Mfg., Inc |
1 |
$201 |
|
Bakersfield Arc, Inc |
2 |
$551 |
|
Bank of America Corp |
1 |
$147 |
|
Big Lots |
1 |
$276 |
|
Blue Shield Of CA |
1 |
$147 |
|
Cal-South Hampton |
1 |
$14 |
|
Compass Group USA |
4 |
$770 |
|
County of Ventura Fire Department |
1 |
$147 |
|
D.D.R. Pizza, Inc |
2 |
$423 |
|
Delta Air Lines, Inc |
1 |
$147 |
|
Deskmakers, Inc |
3 |
$752 |
|
DHL Global Mail |
1 |
$147 |
|
Dollar General Corporation |
2 |
$295 |
|
Entertainment Rent-A-Car Company Of Los Angeles |
3 |
$496 |
|
Evergreen Pharmaceutical Of California |
1 |
$18 |
|
Excel, Inc |
1 |
$147 |
|
Express Services Inc |
4 |
$658 |
|
General Motors |
4 |
$590 |
|
Glendale Memorial Hospital And Health |
1 |
$147 |
|
Glendale Unified School District |
3 |
$910 |
|
Golden State Water Company |
1 |
$147 |
|
Heritage Care, LLC |
1 |
$338 |
|
Hilton Los Angeles/Universal City |
1 |
$147 |
|
Hobby Lobby Stores |
2 |
$295 |
|
Housing Authority City Of Los Angeles |
2 |
$348 |
|
Humangood |
1 |
$147 |
|
Jetsuite, Inc |
1 |
$147 |
|
Jurupa Recreation District/Capri Workers Comp |
1 |
$201 |
|
LA Arena Company, LLC |
1 |
$147 |
|
LA Mission Hills |
1 |
$147 |
|
Lakewood Regional Medical |
1 |
$147 |
|
Langham Hotels Pacific Corporation |
1 |
$147 |
|
Long Drug Stores California, LLC |
3 |
$624 |
|
M S Aerospace Inc |
1 |
$276 |
|
Macy's |
3 |
$570 |
|
McKession Corporation |
2 |
$348 |
|
Millcreek Electrical, Inc |
1 |
$276 |
|
Momentum |
1 |
$147 |
|
Mongomery Ward |
1 |
$380 |
|
Northridge Hospital Medical Center |
1 |
$276 |
|
Northrop Grumman |
20 |
$3,389 |
|
Pacific Bell Telephone Company |
2 |
$641 |
|
Panda Express |
1 |
$201 |
|
Performance Team LLC |
1 |
$380 |
|
Prime Communications L.P. |
1 |
$147 |
|
Public Storage |
1 |
$147 |
|
Restaurant Franchise Captive Program |
1 |
$201 |
|
Ritchie Trucking Services Inc |
1 |
$147 |
|
Ross Stores, Inc |
2 |
$476 |
|
RTW Retailwinds, Inc |
1 |
$201 |
|
Safelite Group, Inc |
1 |
$147 |
|
Santa Clarita Valley School Food Services |
1 |
$147 |
|
Saputo Cheese |
1 |
$276 |
|
SAS Overhead Genops Alb So Cal |
1 |
$147 |
|
Schneider National Carriers |
1 |
$201 |
|
Skywest Airlines, Inc. |
2 |
$402 |
|
Sony Corp of America |
1 |
$421 |
|
Starr Companies |
1 |
$276 |
|
Target Corporation |
12 |
$2,111 |
|
The Boeing Company |
4 |
$750 |
|
The Hertz Corporation |
1 |
$147 |
|
Trader Joe's Company |
6 |
$885 |
|
Tradesmen International, Inc |
1 |
$147 |
|
Transdev Services |
1 |
$147 |
|
Trinity Health |
1 |
$276 |
|
Trustaff Management, Inc |
1 |
$201 |
|
Valley Village |
2 |
$348 |
|
Vanguard Car Rental USA |
1 |
$147 |
|
Ventura County Sheriff |
2 |
$685 |
|
Village Joann Fabric And Crafts |
4 |
$953 |
|
Vons Companies, Inc |
1 |
$201 |
|
Wells Fargo Bank |
3 |
$496 |
|
Western Roadies Inc |
1 |
$147 |
|
YRC Inc |
1 |
$276 |
|
Sedgwick Claims Management Services, Inc. Total |
187 |
$35,611 |
|
Grand Total |
199 |
$38,123 |
DaisyBill provides content as an insightful service to its readers and clients. It does not offer legal advice and cannot guarantee the accuracy or suitability of its content for a particular purpose.