Most Recent Articles
Jul 12, 2018
RFA For Emergency Treatment in California Workers' Comp
First, let’s be clear that providers never have to wait for authorization before providing emergency treatment an acute medical condition. Never.However, the provider ...
Jun 22, 2018
Conditional Authorization: How MPNs Cheat Workers’ Comp Providers
Medical Provider Networks (MPNs) are a drag on California workers’ compensation. Nominally designed to help employers control costs, MPNs rarely achieve more than throwing up...
Jun 6, 2018
Do Not Send RFAs With Bills
When treating an injured worker, a provider must fax the Request for Authorization (RFA) to the fax number designated by the claims administrator. RFAs should never be sent w...
Jun 20, 2018
Data Show MPNs Do Not Benefit Employers
Medical Provider Networks (MPNs) allow employers to limit where employees may seek treatment for work-related injuries. Theoretically, the purpose of MPNs is to direct care w...
May 23, 2018
IMR Unlikely to Overturn UR Decisions
When a payor’s utilization review organization (URO) denies treatment recommended by an injured worker’s treating physician, the only recourse is for the injured worker to ap...
Feb 8, 2018
Treatments That Do NOT Qualify for Automatic Authorization in Workers’ Comp
Automatic authorization for California workers’ comp is in effect, but not all treatments qualify. In fact, the Division of Workers’ Compensation (DWC) has specificall...
Mar 16, 2015
WCAB RFA Cases and Why They Matter, Part II
In my last post I set out why I’m so enthusiastic about Requests for Authorization (RFAs). For those of you who want more detail, I’m going to summarize the act...
Feb 22, 2016
Your Request for Authorization (RFA) Questions Answered
Hands down, answering your questions is the most popular part of our work comp webinars. This post answers some of the most-asked questions from last week’s Request for Autho...
Dec 9, 2016
Authorization and Declaration II: More on RFAs and Liens Under SB 1160
You already know Requests for Authorization (RFAs) as the single most effective tool for guaranteeing payment. Now RFAs play a vital role in lien declaration, as well....
Oct 16, 2014
New RFA Workflow
We had a great Request for Authorization webinar last week and our workflow was a big hit.I think the workflows are so popular because, as we all know, workers' comp is incre...
Nov 10, 2017
How It Works: Independent Medical Review (IMR)
When the claims administrator representing the insurance company, employer, or TPA denies a valid, compliant Request for Authorization (RFA), what’s a work comp provider to d...
Dec 6, 2016
Authorization and Declaration: RFAs and Liens Under SB 1160 (Part I)
It’s something like a motto around here: Billing success starts with authorization success. Submitting a Request for Authorization (RFA) is the best investment a provider can...