In California and other states, payers must respond to providers' electronic bills (e-bills) with electronic Explanations of Review (e-EORs), which automatically post payment details to providers' e-billing systems, saving providers countless hours of administrative work.

Third-Party Administrator (TPA) Cannon Cochran Management Services, Inc. (CCMSI) is in consistent violation of this e-EOR requirement due to its convoluted payment system, which routes providers' reimbursements through its partners, MedRisk and ECHO Health, Inc.

Any employer or insurer currently using CCMSI as their TPA, or considering doing so, should carefully weigh this ongoing non-compliance and its impact on the providers treating their injured workers.

CCMSI often fails to issue e-EORs, or the e-EORs it issues reflect an inaccurate payment amount. This failure forces providers to manually post payments using separate payment information that MedRisk/ECHO delivers. Most importantly, this failure violates state regulatory requirements to send e-EORs in response to e-bills.

The consequences are evident in daisyBill's Claims Administrator and Network Directory, where CCMSI currently holds an Electronic Data Interchange (EDI) “Grade” of D- for e-EOR compliance.

CCMSI failed to issue compliant e-EORs for 26% of the 51,287 e-bills daisyBill providers sent from March 2025 through February 2026. The TPA’s failure to send an e-EOR for more than one in four e-bills costs providers time, creates cash flow uncertainty, and directly violates California's e-billing rules.

e-EORs: CCMSI Is Accountable for Its Omissions

Under California law, CCMSI is directly accountable for what its partners and vendors do on its behalf. Its failure to deliver compliant e-EORs is a failure of a core duty. As the California Division of Workers’ Compensation (CA DWC)’s Electronic Medical Billing and Payment Companion Guide states (emphases ours):

"Electronic billing rules allow for use of agents to accomplish the requirements of electronic billing. Entities using agents are responsible for the acts or omissions of those agents executed in the performance of services for the entity."

Both the CA DWC Medical Billing and Payment Guide and the electronic Companion guide are adopted by reference into California Code of Regulations Section 9792.5.1, and spell out exactly what a compliant e-EOR must include:

• The (accurate) payment amount
• The date of payment
• Line-item payment details
• Reason codes for any adjustments or denials
• The provider's right to appeal the reimbursement through Second Review appeals and Independent Bill Review

Routing payments through MedRisk or ECHO Health does not change CCMSI’s obligation to send providers compliant, valid e-EORs.

Damning daisyBill Data

daisyData demonstrate that CCMSI's EDI performance is seriously off-track. With thousands of missing or invalid e-EORs, CCMSI's EDI score for e-EORs specifically is an appalling 62% (D-).

For every 100 e-bills daisyBill providers submitted to CCMSI, the TPA failed to send a valid e-EOR 26 times.

For CCMSI, this EDI failure may be convenient or even profitable. However, it does not relieve the TPA of its legal obligation to comply with e-billing and payment requirements, nor does it grant CCMSI the right to impose the needless, extraordinary administrative burden of managing its EDI failures on providers.

The harm extends beyond individual providers. When a TPA systematically fails to send compliant e-EORs, it undermines the entire purpose of e-billing: to reduce friction and streamline timely treatment.

Every missing or invalid e-EOR is a tax on provider participation in the system. A TPA with a 26% failure may contribute to eroding access to care for injured workers across all employers and insurers it serves.

Employers and insurers who retain CCMSI to administer their California workers' comp claims should understand how that choice impacts the providers treating their injured workers. When practices cannot post payments automatically, cannot easily reconcile remittance data, and are forced to hunt for reimbursement information through fourth- or fifth-party portals, they may conclude that treating workers covered by that TPA is not worth the administrative hassle.

daisyBill will continue tracking and publicizing data showing that CCMSI has a systemic problem with e-EOR non-compliance that is costing providers time and resources, and ultimately making it harder for practices to accept injured workers as patients.

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