Most Recent Articles
Feb 7, 2018
“Automatic” Authorization, but Denied Bill? How to Appeal the Denial
The new “automatic” authorization process for workers’ comp is in effect, as of January 1. We’ve discussed this new system extensively on our blog and in our recent webinar, ...
Mar 9, 2018
Complete 2018 Automatic Authorization Guide for California Workers’ Comp
Over the last several months, we blogged extensively (and hosted a free comprehensive webinar) on the new automatic authorization process for California workers’ comp. Here, ...
Feb 1, 2018
Fast-Track UR for Workers’ Comp: New Rules for Entities Conducting UR
We spent the last few weeks bringing readers up to speed on the new “automatic” authorization and “fast-track” utilization review (UR) process for workers’ comp. While we’ve ...
Apr 27, 2018
CA Workers' Comp Alert: MTUS Drug Formulary Update
California’s Division of Workers’ Compensation (DWC) ordered an update to the state’s drug formulary, effective May 15. The update adds 20 drugs to the formulary and r...
Aug 4, 2017
Why the RFA System Is Broken
Every day, we hear from frustrated providers across California who are struggling with their Requests for Authorization (RFAs). Their RFAs take too long to submit, and often ...
Feb 16, 2018
Authorization/Utilization Review: Why Peer-to-Peer Calls Are a Bad Idea
There’s been lots to say about authorization and utilization review (UR) this year, especially given the major changes to the process. However, one UR rule that remains the s...
Dec 14, 2017
In Workers' Comp, Authorization Is Final
Let’s be very clear: in the workers’ comp dialect of Legalese, “authorization” means guaranteed payment for approved services. Period.While one can imagine scenarios i...
Dec 1, 2017
2018 Authorization/Utilization Review: Major Changes Effective 1/1/2018
Senate Bill 1160 makes significant changes to the authorization and utilization review (UR) process starting in 2018. New “fast-track” UR takes effect on January 1. Fa...
Oct 12, 2017
Just in Time: RFA and Utilization Review Timeframe Requirements
In California, proper authorization is one of the most important factors for compliance in workers’ comp billing and payment. Legally, “authorization” is the insurer’s accept...
Nov 9, 2017
FYI: Claims Admin Not Required to Use RFA Form
A provider’s office recently asked if claims administrators must sign and return the Division of Workers’ Compensation (DWC)’s official RFA form when approving the requested ...
Oct 27, 2017
DWC’s Proposed Denial of Claims Notice Lacks Clarity
When an employer denies an employee’s workers’ comp claim, California law mandates that the employer must inform the employee of their right to seek medical treatment outside...
Jun 29, 2017
Don’t Be Fooled: Authorization Guarantees Payment
A DaisyBill provider recently emailed our headquarters with an interesting scenario. The provider agreed to treat an injured worker, received authorization for services, perf...