Third-Party Administrator (TPA) Sedgwick Claims Management Services, Inc. makes frequent appearances in daisyNews for its persistent, well-documented pattern of violating California workers’ comp payment laws and regulations.

Adding to its voluminous record of failure and general provider torture, Sedgwick representatives are asserting that Sedgwick is not the TPA handling claims for the University of California (UC), when it is.

Sedgwick is the largest workers’ comp TPA in the state and the nation, handling claims for a massive portfolio of employers and insurers. While Sedgwick maintains an internal bill review department, some Sedgwick clients also engage Genex to conduct bill review on their behalf. UC is one such Sedgwick client, as hundreds of UC bills sent through our system over the last several months demonstrate.

However, on multiple occasions, Sedgwick representatives have told daisyBill agents inquiring about unpaid electronic bills (e-bills) that Sedgwick is not the University of California’s TPA.

When our agents contacted Genex to track down the missing payments, a Genex representative claimed that Sedgwick does not accept e-bills, which is patently untrue (and would be illegal if it were true).

Between Sedgwick and Genex, providers treating injured UC employees face far too many unnecessary obstacles to payment. This is the predictable result of UC engaging one of the least compliant payers in the state (Sedgwick) and engaging a bill review vendor with its own misinformation problem (Genex).

Ironically enough, two UC health systems refuse to treat injured workers.

According to a June 2026 white paper from the American Association of Payers, Administrators & Networks (AAPAN), UC Los Angeles and UC San Francisco, along with Stanford and Cedars-Sinai, have chosen not to treat workers’ comp patients.

AAPAN attributes this to a general nationwide physician shortage. A UC clinical director offered daisyBill a simpler explanation: they “won’t touch workers’ comp because we can’t get paid.”

UC’s health systems have experienced how hard it is to get paid for treating injured workers. Yet, its choice of TPA to handle its own employees’ comp claims exacerbates the exact problems driving providers out of the system.

Sedgwick Denies Its Own Client

daisyBill called Sedgwick to investigate one of several missing payments for one of our client’s UC e-bills. On the call, a Sedgwick representative asked for the claim number and the injured worker’s name before (incorrectly) reporting that Sedgwick is not the TPA for UC, stating (emphasis ours):

“Alright. See, I’m showing that this client is University of California and it says that we need to refer you to the employer or the claimant because we are no longer the TPA or bill review...”

We then contacted Genex, the designated bill reviewer for UC claims, to confirm whether they had the bill on file. The Genex representative confirmed the claim and provided the Sedgwick claims adjuster’s contact information, but reported that the e-bill was not on file.

Genex Claims Sedgwick Doesn’t Accept e-Bills

daisyBill placed another call to Sedgwick regarding a different missing payment. After requesting the bill date of service and the charge amount, a Sedgwick representative once again claimed that Sedgwick is no longer the TPA for UC claims (emphasis ours):

“...upon checking here, yeah, we do receive this bill. But as upon checking here we’re not the TPA or…bill review for this client. So, I suggest to reach out [to] the employer for this one.”

Once again, we followed up with Genex to confirm that daisyBill was submitting the missing e-bills using the correct Payer ID number for Sedgwick. On the phone, a Genex representative bafflingly stated “I don’t think they have a Payer ID,” before claiming that Sedgwick doesn’t accept e-bills and instructing us to snail-mail the bills (emphases ours):

“Okay, so they just answered and they said that no…they only have mailing option right now. So would you like the mailing address? Yeah, unfortunately…no electronic filing, yeah. Okay, so the mailing address I have for them is gonna be PO Box 14533, Lexington, Kentucky, ZIP code 40512.”

For the record:

• California Labor Code Section 4603.4 requires all workers’ comp payers to accept e-bills
• Sedgwick accepts hundreds of thousands of our clients’ e-bills annually, as reflected in our data (Sedgwick is abysmal at handling those e-bills, but it does accept them).

Of course, this isn’t the first time Genex incorrectly claimed that one of its clients doesn’t accept e-bills.

UC pays Sedgwick and Genex to handle its injured employees’ claims, and should demand that both stop misrepresenting the facts. Providers treating UC employees deserve straight answers and timely payment, and UC is the only party with the leverage to make that happen.

Meanwhile, providers should know the facts: Sedgwick is the University of California’s TPA, and the law requires it to accept e-bills. If a Sedgwick or Genex representative tells you otherwise, they’re astoundingly misinformed.

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