A California workers’ comp physician recently received eight checks totaling $110,858 from Careworks, a vendor affiliated with Third-Party Administrator (TPA) Sedgwick.
Those checks didn’t pay for a single employer’s injury claims—or even a single claims administrator. Instead, they covered 566 medical bills for 311 injured workers across 139 different employers.
Careworks even mixed in bills for injured employees covered by entirely different entities, including QBE North American, National Interstate Insurance, and AmeriTrust Group, Inc.
When viewed through the lens of these 566 payments, employers face an opaque system that makes it extremely difficult to track their money through Sedgwick’s vendor relationships.
Just as alarmingly, daisyData from Sedwick's electronic Explanations of Review (e-EORs) show that:
Sedgwick pools employer dollars with funds from hundreds of other employers and routes them through Careworks. The result is that employers may have no choice but to rely on Sedgwick’s reporting to understand where payments went. This obscures financial accountability and creates administrative chaos for employers and providers trying to reconcile records, resolve disputes, and ensure compliance.
Additionally, all 566 payments were untimely under California law and failed to include the mandatory e-EOR. This forces practice staff to spend hours manually parsing and posting payments to each bill.
Sedgwick’s practices result in an accounting and revenue management nightmare for providers in violation of state requirements. The 139 employers we list below deserve to know where their money is going, to whom, and for what purposes.
daisyBill will file Audit Complaints for every single one of Sedgwick’s violations of state workers’ comp law.
Unfortunately, employers should harbor no illusions that the California Division of Workers’ Compensation (CA DWC) will step in. The agency’s track record suggests that ignoring Sedgwick’s abuses outweighs any obligation to protecting providers or injured workers.
Employers expect that their money will cover the care of their injured employees. But when Sedgwick funnels employer dollars through Careworks, those dollars enter opaque processes that employers can’t follow. Employers must rely on Sedgwick’s reporting to determine whether their money funds treatment and recovery.
Of course, as history and daisyData make clear, Sedgwick’s compliance record is dismal, and the payment data they send to daisyBill is consistently error-filled.
While doctors can choose to leave the system, employers cannot—they must continue paying for workers’ comp coverage and hoping to get what they’re paying for. If you’re one of the 139 companies below whose money was tossed into this opaque payment system—which resembles a game of 139-Card Monte—it’s time to demand answers.
Employers must pressure Sedgwick to:
The CA DWC won’t force Sedgwick to change its behavior. Providers are powerless to do so. It’s up to employers to demand better for their employees.
Claims Administrator |
Employer |
Bill Count |
Payment Amount |
Sedgwick Claims Management Services, Inc. |
Northrop Grumman |
71 |
$13,281 |
Target Corporation |
33 |
$6,041 |
|
Amazon.com, Inc. |
29 |
$5,531 |
|
AT&T SERVICES, INC |
24 |
$4,414 |
|
The Boeing Company |
11 |
$3,504 |
|
Traders Joe's Company |
21 |
$3,406 |
|
Compass Group USA |
13 |
$2,897 |
|
Pacific Bell Telephone Company |
13 |
$2,551 |
|
Glendale Unified School District |
9 |
$2,420 |
|
Valley Village |
11 |
$2,273 |
|
AHGL-Adventist Health Glendale |
12 |
$2,272 |
|
ABM INDUSTRIES |
9 |
$2,174 |
|
ANHEUSER-BUSH, INCORPORATED |
11 |
$1,803 |
|
General Motors |
8 |
$1,719 |
|
DESKMAKERS, INC |
6 |
$1,578 |
|
Express Services Inc |
8 |
$1,557 |
|
ENTERPRISE RENT-A-CAR |
8 |
$1,415 |
|
Housing Authority CIty of Los Angeles |
7 |
$1,353 |
|
Ross Stores, Inc |
7 |
$1,321 |
|
Ventura County Sheriff |
4 |
$1,320 |
|
YRC INC FREIGHT |
7 |
$1,214 |
|
Long Drug Stores California, LLC |
6 |
$1,194 |
|
Wells Fargo Bank |
7 |
$1,193 |
|
Hobby Lobby Stores |
6 |
$1,127 |
|
DOLLAR GENERAL CORPORATION |
7 |
$1,086 |
|
Mongomery Ward |
3 |
$1,015 |
|
VILLAGE JOANN FABRIC AND CRAFTS |
4 |
$953 |
|
Macy's |
5 |
$865 |
|
BAKERSFIELD ARC, INC |
3 |
$827 |
|
Montague Charter Academy |
2 |
$803 |
|
DHL EXPRESS, INC |
3 |
$752 |
|
ARCHDIOCESE OF LOS ANGELES |
3 |
$752 |
|
PERFORMANCE TEAM LLC |
3 |
$729 |
|
TRINITY HEALTH |
2 |
$631 |
|
Humangood |
3 |
$624 |
|
D.D.R. PIZZA, INC |
3 |
$624 |
|
2452 CENTRE POINT/VILLAGE JOANN FABRIC & CRAFTS |
3 |
$603 |
|
Hub Group Inc |
3 |
$594 |
|
PUBLIC STORAGE |
4 |
$590 |
|
STARR COMPANIES |
2 |
$551 |
|
Saputo Cheese |
2 |
$551 |
|
RANCHO SIMI RECREATION AND PARK DISTRICT/CAPRI WORKERS COMP |
2 |
$551 |
|
MILLCREEK ELECTRICAL, INC |
2 |
$551 |
|
M S AEROSPACE INC |
2 |
$551 |
|
Skywest Airlines, Inc. |
3 |
$549 |
|
MCKESSION CORPORATION |
3 |
$549 |
|
AVELO AIRLINES, INC |
2 |
$516 |
|
VONS COMPANIES, INC |
3 |
$496 |
|
THE HERTZ CORPORATION |
3 |
$496 |
|
HERITAGE CARE, LLC. |
2 |
$486 |
|
TRUSTAFF MANAGEMENT, INC |
2 |
$476 |
|
Super King Market |
2 |
$476 |
|
Panda Express |
2 |
$476 |
|
JURUPA RECREATION DISTRICT/CAPRI WORKERS COMP |
2 |
$476 |
|
LAKEWOOD REGIONAL MEDICAL |
3 |
$442 |
|
GROUND SERVICES INTERNATIONAL |
3 |
$442 |
|
ALBERTSON'S |
2 |
$423 |
|
Sony Corp of America |
1 |
$421 |
|
RESTAURANT FRANCHISE CAPTIVE PROGRAM |
2 |
$402 |
|
Montebello Unified School District |
2 |
$402 |
|
American Textile Maintenance |
2 |
$402 |
|
Morley Builders Inc. |
2 |
$398 |
|
SCHNEIDER NATIONAL CARRIERS |
2 |
$348 |
|
SANTA CLARITA VALLEY SCHOOL FOOD SERVICES |
2 |
$348 |
|
RTW RETAILWINDS, INC |
2 |
$348 |
|
Prime Communications L.P. |
2 |
$348 |
|
Langham Hotels Pacific Corporation |
2 |
$348 |
|
LA Missions Hills |
2 |
$348 |
|
Farmers Group, Inc. |
2 |
$348 |
|
COUNTY OF VENTURA FIRE DEPARTMENT |
2 |
$348 |
|
7-Eleven |
2 |
$348 |
|
1556 Cahuenga Partners, LLC |
1 |
$328 |
|
WKS Restaurant Corporation |
2 |
$295 |
|
WESTERN ROADIES INC |
2 |
$295 |
|
VANGUARD CAR RENTAL USA |
2 |
$295 |
|
Transdev Services |
2 |
$295 |
|
Tradesmen International, Inc |
2 |
$295 |
|
SAS RETAIL SERVICES |
2 |
$295 |
|
SAS OVERHEAD GENOPS ALB SO CAL |
2 |
$295 |
|
RITCHIE TRUCKING SERVICES INC |
2 |
$295 |
|
SAFELITE GROUP, INC |
2 |
$295 |
|
PJCA-6 |
2 |
$295 |
|
McGee Air Services |
2 |
$295 |
|
LA ARENA COMPANY, LLC |
2 |
$295 |
|
Golden State Water Company |
2 |
$295 |
|
GOLDEN ROAD BREWERY-SAN FERNANDO |
2 |
$295 |
|
Glendale Memorial Hospital and Health |
2 |
$295 |
|
FIRST TRANSIT INC |
2 |
$295 |
|
Excel, INC |
2 |
$295 |
|
Ecology Auto Parts, Inc. |
2 |
$295 |
|
DOLLAR TREE STORES |
2 |
$295 |
|
Delta Air Lines, Inc |
2 |
$295 |
|
CVS Pharmacy |
2 |
$295 |
|
CEC ENTERTAINMENT INC |
2 |
$295 |
|
BLUE SHIELD OF CA |
2 |
$295 |
|
AHSV-ADVENTURES HEALTH SIMI VALLEY |
2 |
$295 |
|
Whittier Area Schools Insurance Authority |
1 |
$276 |
|
Penny Lane Centers |
1 |
$276 |
|
Northridge Hospital Medical Center |
1 |
$276 |
|
National Alamo/ Enterprise Holding |
1 |
$276 |
|
Big Lots |
1 |
$276 |
|
AGGCAO Arch #3 |
1 |
$276 |
|
3B HOLDING COMPANY |
1 |
$276 |
|
AHWM- Adventist Health White Memorial |
2 |
$215 |
|
William S. Hart High School |
1 |
$201 |
|
JC Penney |
1 |
$201 |
|
Avibank MFG., Inc |
1 |
$201 |
|
ASCIP |
1 |
$201 |
|
Walgreens |
1 |
$147 |
|
TCI TRANSPORTATION SERVICES, INC. |
1 |
$147 |
|
ST. JOHN'S PLEASANT VALLEY HOSPITAL |
1 |
$147 |
|
SAS OVERHEAD-GENOPS-KROGER-FOOD 4 |
1 |
$147 |
|
MOMENTUM |
1 |
$147 |
|
LOS ANGELES SEPULVEDA/ THE PARKING SPOT |
1 |
$147 |
|
Jetsuite, Inc |
1 |
$147 |
|
Hilton Los Angeles/Universal City |
1 |
$147 |
|
High Desert Gateway |
1 |
$147 |
|
DHL Global Mail |
1 |
$147 |
|
DFA Dairy Brands Fluids, Inc |
1 |
$147 |
|
Cor Restaurant Services |
1 |
$147 |
|
Calportland Company |
1 |
$147 |
|
Brightspring Healthcare Services |
1 |
$147 |
|
Bank of America Corp |
1 |
$147 |
|
ADVANCED STERLIZATION PRODUCTS |
1 |
$147 |
|
Lee's Maintenance Service Inc |
1 |
$49 |
|
EVERGREEN PHARMACEUTICAL OF CALIFORNIA |
1 |
$18 |
|
Cal-South Hampton |
1 |
$14 |
|
Sedgwick Claims Management Services, Inc. Total |
542 |
$106,017 |
|
QBE North American |
BLUE CITY HOLDINGS, LLC |
1 |
$610 |
IDG HOLDCO, LLC |
2 |
$476 |
|
Tower Wav, LLC |
2 |
$402 |
|
GREEN 16, LLC |
2 |
$348 |
|
MSX INTERNATIONAL, LLC |
1 |
$147 |
|
QBE North American Total |
8 |
$1,984 |
|
National Interstate Insurance |
STORER TRANSPORTATION |
4 |
$581 |
Thompson & Harvey Bay Area, LLC |
3 |
$507 |
|
STUDENT TRANSPORTATION OF AMERICA |
2 |
$448 |
|
National Interstate Insurance Total |
9 |
$1,537 |
|
AmeriTrust Group, Inc. |
Kern Harvesting, Inc |
2 |
$402 |
TROPHY AUTOMOTIVE DEALER GROUP |
2 |
$348 |
|
Cal Enterprise Labor Solutions |
2 |
$295 |
|
POZZI HILL, INC |
1 |
$276 |
|
AmeriTrust Group, Inc. Total |
7 |
$1,320 |
|
Grand Total |
566 |
$110,858 |
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.