Most Recent Articles
Nov 4, 2021
AIG & Coventry (and California) Squeeze QME
California Medical-Legal physician evaluators, be advised: some payers still attempt to improperly apply Preferred Provider Organization (PPO) discounts to Medical-Legal bill...
Dec 8, 2021
Download: Med-Legal "Superbill"
Medical-Legal billing for California workers’ comp is like…well, anything in California workers’ comp: a big mess.It’s convoluted, and physicians get nearly zero help ...
Jan 21, 2022
Med-Legal Data: MLPRR Charges Continue to Climb
California Medical-Legal record review expenses soared into the wide blue yonder after the Division of Workers’ Compensation (DWC) updated the Medical Legal Fee...
Jan 20, 2022
MLPRR: Record Review Guide for CA Med-Legal MDs
Millions of pages. Millions of dollars. Potentially serious consequences for non-compliance.Medical-Legal record review can be a big challenge for physician evaluators...
Jan 30, 2022
Costco: Helmsman Tries to Skirt Missed Appointment Fee
Denying payment to a Medical-Legal physician by falsely deeming a service non-compensable is a common — and contemptible — transgression. But Helmsman Management Serv...
Jan 28, 2022
Med-Legal Emergency Regulations Extended
The California Division of Workers’ Compensation (DWC) recently announced that the proposed Qualified Medical Evaluator (QME) Emergency Regulation found in California Code of...
Feb 7, 2022
CA Med-Legal Reports: REQUIRED Physician Verification
Last spring, California introduced a new Medical-Legal Fee Schedule (MLFS). Since April 2021, daisyBill clients have submitted over 80,000 medical-legal bills where the new M...
Feb 4, 2022
MLPRR: Costco/Helmsman Play Med-Legal IBR Chicken
Call it “IBR Chicken: MLPRR Edition.” Third-party claims administrator (TPA) Helmsman, acting on behalf of self-insured employer Costco, refused to reimburse a physici...
Feb 3, 2022
Med-Legal MLPRR: CorVel Caps Units - Review EORs Carefully
California released an updated Medical-Legal Fee Schedule (MLFS) for workers’ compensation, effective April 1, 2021. Physicians had high hopes that the update, which introduc...
Feb 9, 2022
ESIS Refuses to Answer Phone or Pay Med-Legal Doctor
ESIS, a third-party administrator (TPA) for Ace American Insurance, is failing miserably in its legal duty to timely reimburse a California physician evaluator for Medical-Le...
Apr 7, 2022
CA Med-Legal: How to Appeal Unpaid AME Modifier -94
Regularly, California workers’ comp claims administrators incorrectly deny Medical-Legal Fee Schedule (MLFS) modifier -94 for Agreed Medical Evaluator (AME) services. In this...
Apr 27, 2022
CA Med-Legal How-To: Collect Penalty & Interest Payments
California physician evaluators, be advised: when claims administrators are late in paying for Medical-Legal services, penalty and interest payments apply. However, inadequat...