Most Recent Articles
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...
Apr 21, 2022
ESIS Continues to Refuse Payment for Med-Legal Evaluations
Third-party claims administrator (TPA) ESIS systematically refuses to pay bills for Medical-Legal services. Full stop. Below, we list 9 Medical-Legal bills — some more...
Apr 27, 2022
CA Med-Legal: $76 Million Owed For Record Review in First Year
It’s been just over a year since California adopted the new Medical-Legal Fee Schedule (MLFS). Effective April 1, 2021, the new MLFS represented the first incre...
May 10, 2022
Med-Legal: Cannon Cochran Denies Payment for Interpreter Services
Medical-Legal physician evaluators, be advised: a disturbing payment denial tactic is catching on among California claims administrators. When responding to physician ...
May 10, 2022
Free: CA Med-Legal "Superbills"
Medical-Legal billing for California workers’ comp is fraught with complications, contradictions, and — of course — threats to physician revenue from less-than-scrupulous ent...