Most Recent Articles

Tennessee Just Showed the Way For California to Fight PPOs

California employers are getting fleeced twice over.First, the Workers' Compensation Insurance Rating Bureau (WCIRB) recommended a 10.4% premium hike on top of last ye...

Data: PPOs Are Another “Cost Control” Measure That Hurts CA Employers

California employers pay more than almost any other state for comp coverage, with premiums set to rise again in September. California claims take twice as long and cost twice...

CA Billing Alert: Alisal Union Schools’ TPA Pays Below Medicare Rates

California’s fee schedule for workers’ comp treatment pays physicians more than Medicare rates (currently 55% more) to account for the extraordinary time, work, and administr...

Paradigm’s 96-Page “Frankenstein” EOR Covers ~400 Bills

Paradigm Specialty Networks created a 96-page Frankenstein’s monster of an Explanation of Review (EOR), stitched together from hundreds of bills for mult...

CA: How Paradigm Intercepts Employers’ Comp Dollars

This article has been corrected. See notes at the end.Private equity is profiting from funds intended for the care of injured workers. California employers, regulators...

Zurich, Paradigm Hit CA Provider With $786 Reduction (and $195 IBR Fee)

This article has been corrected. See notes at the end.Paradigm Specialty Networks functions as a twisted sort of toll collector, inserting itself ...

Warning: ECHO Deducts "Service Fee" From Paradigm Payment

This article has been corrected. See note at the end.As daisyNews explored in recentarticles, Paradigm Specialty Networks profits by...

Network Mayhem: Sedgwick & Apricus Stiff CA Provider

A California provider received no reimbursement for treating an injured worker, with no clear path to payment, thanks to an apparent accounting dispute between Third-Party Ad...

Liberty Mutual's “Payment Holiday”: A Vacation From CA Law

daisyBill submits millions of bills for injured workers' treatment every year. We've heard every excuse payers can produce for failing to reimburse, but Liberty Mutual just s...

FedEx: Sedgwick & Genex Bungle Payment (Again)

Once again, Third-Party Administrator (TPA) Sedgwick Claims Management Services authorized treatment for an injured FedEx employee, only to refuse to pay for it. More concern...

Sedgwick & Apricus Dispute Leaves Provider Unpaid (Again)

A California provider is missing thousands in reimbursement for authorized treatment due to (another) circular dispute between the Third-Party Administrator (TPA), Sedgwick C...

ESIS and Its Unreachable Adjuster Fail to Respond to e-Bills

Third-Party Administrator (TPA) ESIS completely failed to respond to multiple electronic bills (e-bills) for an injured Allied Universal employee’s treatment by the legally m...