Most Recent Articles
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Aug 18, 2022
LWP Invalid 277 ACKs: Non-Compliant STC Category-Code Payment Denial - 339 Audit Complaints
Third-Party Administrator (TPA) LWP Claims Solutions is in violation of California workers’ comp e-billing law. LWP’s persistent failure to honor state requirements places an...
Aug 18, 2022
LWP Invalid 277 ACKs: Non-Compliant Rejections for Second Review Appeals - 102 Audit Complaints
Third-Party Administrator (TPA) LWP Claims Solutions is in violation of California workers’ comp e-billing law. LWP’s persistent failure to honor state requirements places an...
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Aug 18, 2022
LWP Non-Compliant 835 e-EORs: Untimely or Missing - 1,785 Audit Complaints
Third-Party Administrator (TPA) LWP Claims Solutions is in violation of California workers’ comp e-billing law. LWP’s persistent failure to honor state requirements places an...
Aug 18, 2022
LWP Non-Compliant 835 e-EORs: Invalid and Unpostable - 1,960 Audit Complaints
Third-Party Administrator (TPA) LWP Claims Solutions is in violation of California workers’ comp e-billing law. LWP’s persistent failure to honor state requirements places an...
Sep 15, 2022
Data! Top 10 Claims Admins: CA Electronic EOR Compliance
Electronic Explanations of Review (e-EORs) are a non-negotiable requirement of workers’ comp electronic billing. Within 15 working days of receiving a provider’s e-bill, the ...
Sep 15, 2022
Berkshire Hathaway Repairs Electronic EOR Issue
There’s no excuse for claims administrators not to accept and properly process electronic bills, a legal requirement in California for almost 10 years now. Ever...
Sep 15, 2022
AmTrust Addresses Electronic EOR Issue
Insurer AmTrust North America provided an excellent example of how claims administrators, working in good faith with providers, can resolve Electronic Data Interchange (EDI) ...
Sep 26, 2022
An Open Letter to Sedgwick Claims Management Services, Inc.
Dear Sedgwick Claims Management Services,This is a plea. In all sincerity, and all snark aside, California workers, providers, and employers need you to do bett...
Dec 8, 2022
2022 Non-Compliance Report: 6 Admins That Fail to Send e-EORs
California workers’ comp switched to electronic billing for very good reasons. e-Billing is much, much faster, wastes far fewer resources, and goes a very long way tow...
Dec 14, 2022
Sedgwick's 57,876 Audit Complaints: A Business Practice?
Sedgwick received our open letter, but the Third-Party Administrator (TPA) still missed the memo. Sedgwick administers claims on behalf of insurers and self-insured em...
Dec 14, 2022
Sedgwick Missing e-EORs: 31,906 Audit Complaints Submitted
Sedgwick Claims Management Services is breaking the law. We encourage the California Division of Workers’ Compensation (DWC) to assert its role in upholding workers’ comp law...
Jan 5, 2023
Tristar: 16,459 Audit Complaints Filed
For all its complexity, California workers’ comp has one very simple law: if a doctor chooses to send bills electronically, the claims administrator must accept that doctor’s...