Most Recent Articles

ESIS Makes Bonkers “Offer” to Pay Doctor 45% of Fee Schedule Rate

At daisyNews, we see the complex and sophisticated mechanisms payers use to slash reimbursement for providers treating injured workers. …but sometimes, there’s nothing...

Sedgwick (Still!) Owes CA Practice $500k+ After Bogus PPO Discounts

Sedgwick Claims Management Services,Inc. has withheld hundreds of thousands of dollars in reimbursement from a single California orthopedic practi...

CA: “Lack of Effort” re: Debit Cards Shows Payers' Priorities

Workers’ Comp Executivereports that California payers show little interest in paying injured workers indemnity benefits with debit cards despite a...

Deranged Zenith “Offers” Doctor 31% State Fee Schedule for DME

Workers’ comp has plummeted to a new low in payers’ relentless attempts to deny fair payment to the doctors who treat injured workers.The Zenith’s recent effort to pay...

Provider Alert: Do Not (Not!) Sign PhysNet Discount “Agreement”

A California provider narrowly avoided financial pain when their office signed (but thankfully never delivered) a reimbursement discount agreement PhysNet sent to the practic...

Denials/Reductions for Insufficient E/M Documentation Continue

We recently warned providers about an emerging trend among California workers’ comp claims administrators: denying payment for Evaluation and Management (E/M) services in the...

MARS & MultiPlan Threaten MD With "Intervention" (Part 1)

A California doctor sent a bill to a Third-Party Administrator (TPA), for treatment the TPA had authorized. In response, the doctor received a fax from Medical Audit & Review...

MARS & MultiPlan Threaten MD With “Intervention” (Part 2)

As daisyNews reported yesterday, a California doctor received an unsolicited "agreement" from Medical Audit & Review Solutions (MARS) pressuring the doctor to accept steep pa...

Gold Star: CA State Fund Reverses Denial, Pays Penalties & Interest

Improper payment denials and reductions are inevitable for providers who treat injured workers (more so than in group health or Medicare, which is why many physicians avoid w...