Most Recent Articles

PPO Discounts STILL NOT Applicable to Med-Legal
May 10, 2022
PPO Discounts STILL NOT Applicable to Med-Legal
It’s hard to believe we still have to write this — or is it? California claims administrators may not apply Preferred Provider Organization (PPO) reductions to physici...
DWC Seeks QMEs for October Exam
Jul 13, 2022
DWC Seeks QMEs for October Exam
California’s Division of Workers’ Compensation (DWC) is accepting applications from physicians for the October 2022 Qualified Medical Evaluator (QME) exam.The in-perso...
CA Med-Legal Fees, QMEs Under Attack
Jul 27, 2022
CA Med-Legal Fees, QMEs Under Attack
A recent study on the current Medical-Legal Fee Schedule (MLFS) has triggered a wave of pearl-clutching by payer advocates. So what has the payer-side pundits groping for the...
(Free, Transparent) CA Med-Legal Fee Schedule Data
Aug 4, 2022
(Free, Transparent) CA Med-Legal Fee Schedule Data
As the California Workers’ Compensation Institute (CWCI) peddles paid access to its insurer-derived data and white-tie webinars, daisyBill would like to offer an update on th...
ESIS: 10 Audit Complaints Filed With CA DWC
Aug 11, 2022
ESIS: 10 Audit Complaints Filed With CA DWC
California law requires claims administrators to send an Explanation of Review (EOR) and payment to the physician within 60 days of receiving a bill for Medical-Legal service...
Warning: ESIS (Still) Ignoring CA Medical-Legal Bills
Aug 11, 2022
Warning: ESIS (Still) Ignoring CA Medical-Legal Bills
How else can we put this? Sometimes ESIS, a Third-Party Administrator (TPA), just flat-out ignores bills for Medical-Legal services. Below, daisyBill documents how ESI...
DWC Proposes More Time to Schedule QME Appointment
Oct 6, 2022
DWC Proposes More Time to Schedule QME Appointment
California’s Division of Workers’ Compensation (DWC) will hold a public hearing on significant proposed changes to the regulations governing Medical-Legal evaluations.
CA Med-Legal: Q&A for Confused Physicians
Nov 8, 2022
CA Med-Legal: Q&A for Confused Physicians
Recently, a physician evaluator reached out to us with questions regarding Medical-Legal services for California workers’ comp. Rather than share the answers with this physic...
Midwest Insurance Fails to Pay QME
Nov 8, 2022
Midwest Insurance Fails to Pay QME
If there’s any doubt regarding why California workers’ comp is facing a shortage of Qualified Medical Evaluators (QMEs), look no further than Midwest Insurance. Midwest has b...
ALERT: Municipal Pooling Authority Bounces QME Check (Twice)
Nov 8, 2022
ALERT: Municipal Pooling Authority Bounces QME Check (Twice)
The Municipal Pooling Authority (MPA) recently bounced a check to a California Qualified Medical Evaluator (QME) — not once, but twice. According to MPA representative...
Med-Legal Data: IBR Is the QME/AME's Friend
Dec 8, 2022
Med-Legal Data: IBR Is the QME/AME's Friend
California workers’ comp presents serious challenges to physicians — and Medical-Legal physicians are no exception. Despite a recently simplified Medical-Legal Fee Sch...
CA QME Calls Out Cannon Cochran "Abuse and Insults"
Dec 8, 2022
CA QME Calls Out Cannon Cochran "Abuse and Insults"
A California Qualified Medical Evaluator (QME) has had quite enough nonsensical reimbursement games from Cannon Cochran Management Services, Inc. (CCMSI).The Third-Par...