Most Recent Articles
May 21, 2024
CA: Del Taco Fails to Pay for Injured Employees
Need (yet another) illustration of what happens when a state establishes a consequence-free environment for workers’ comp claims administrators? There is currently no ...
May 23, 2024
The Hartford Goose Chase Ends - "Hartless" Pays Up
In a previous article, we detailed the burdensome (and unwarranted) process required for a provider to determine the reason The Hartford inexplicably failed to reimburse a QM...
Jun 4, 2024
CA Payment Denial Rates - Top 20 Claims Administrators
Bill data collected from daisyBill clients during the first four months of 2024 reveal claims administrators’ disturbing propensity to refuse payment for injured workers’ tre...
Jun 20, 2024
99¢ Stores: Athens Halts Processing Bills
In April of this year, 99 Cents Only Stores LLC declared bankruptcy, leaving the self-insured employer with no way to pay its Third-Party Administrator (TPA), Athens Administ...
Jun 24, 2024
acūrrō Reprocesses Underpaid CA Bills
Sometimes, seeking correct reimbursement for treating injured workers doesn’t require a battle between providers and payers. Claims administrators and their vendors ca...
Jul 2, 2024
Sedgwick Stiffs AME for IBR Filing Fee
In California, when Independent Bill Review (IBR) overturns a Sedgwick erroneous reimbursement denial, Sedgwick owes the provider $180 (the cost of the f...
Jul 10, 2024
CA: Orthopedists Payment Data - Part 1
Orthopedic providers are vital to workers’ compensation. daisyData reveals that since January 1, 2022, Preferred Provider Organization (PPO) entities have diverted over $18 m...
Jul 11, 2024
CA: Orthopedist Payment Data by Claims Admin - Part 2
While all providers who agree to treat injured workers are essential, in this series, daisyBill focuses on orthopedic reimbursement to expose how California’s Medical Provide...
Jul 12, 2024
CA: Orthopedist Bill Denial Rates by Claims Admin - Part 3
In the firsttwo of this series (read here and here), daisyData from orthopedic surgeon clients highlights how California’s convoluted Medical Provider Ne...
Oct 22, 2024
Sedgwick Stiffs CA Practice for Over $300,000
In California, claims administrators can siphon staggering amounts of revenue from practices using invalid Preferred Provider Organization (PPO) discounts—and doctors have no...
Oct 31, 2024
LA Metro Transit Authority: 4,955 Audit Complaints Filed
The Los Angeles County Metropolitan Transit Authority (LA Metro) is making it harder for California doctors to treat its injured employees—and has given no indication of taki...
Nov 11, 2024
CA: USC Switches Workers' Comp TPA
The University of Southern California (USC), a self-insured employer, has switched the Third-Party Administrator (TPA) it uses to handle workers’ comp claims for its injured ...