Most Recent Articles
Oct 4, 2022
WCIRB Report Obscures CA Workers' Comp's Real Challenges
A report from the Workers’ Compensation Insurance Rating Bureau (WCIRB) of California asserts that in 2021, “overall medical payments per claim increased significantly.” Howe...
Feb 7, 2023
Data: Zenith Pays Medicare Rates for E/M Services
According to data from over 10,000 e-bills submitted for 2022 dates of service via daisyBill, insurer The Zenith paid 76% of the reimbursement rates established by California...
Feb 8, 2023
Data: SCIF Pays Medicare Rates for E/M Services
Like The Zenith, California’s State Compensation Insurance Fund (SCIF) consistently pays Medicare rates to doctors for treating injured workers.According to data from ...
Feb 9, 2023
E/M Data: CPT 99214 Reimbursement 2022
Far too often, California providers are not receiving Official Medical Fee Schedule (OMFS) rates for Evaluation and Management (E/M) for injured workers — as evidenced by our...
Mar 20, 2023
Mirage Provider Networks: Sedgwick Can't Identify MPN
At this point, Medical Provider Networks (MPNs) can feel like little more than a cruel joke, offering seemingly ephemeral benefits to providers while exacting a heavy toll in...
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Mar 23, 2023
ACE / Sedgwick Low Payments Reveal PPO Problem
If you’ve ever wondered why so many California doctors avoid treating injured workers, stop wondering. Three separate bills from the same provider to the same insurer...
Mar 29, 2023
MPNs: Why MDs Won't Treat Injured Workers
The video replay of our free webinar on Preferred Provider Organization (PPO) discounts is now available to stream! The webinar slide deck is also available to download.<...
Apr 6, 2023
Sedgwick, Please Accept a Free Gift From daisyBill
Sedgwick Claims Management Services, daisyBill is here for you.We notice that you struggle mightily with correctly calculating reimbursements under California’s...
Apr 12, 2023
Marriott - Networks Pocket Doctors' Pay
Does the Marriott hotel chain know where the money really goes when it pays for its employees’ medical treatment?Self-insured and with its own in-house claims administ...
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Apr 13, 2023
How Networks & MPNs Decimated CA Physical Therapists
To grasp just how ruinous Medical Provider Networks (MPNs) can be for California providers and injured workers, look no further than the tragic situation of physical therapis...
May 17, 2023
SCIF vs Gallagher Bassett: E&M Reimbursement
When evaluated on key metrics such as denial of payments and reimbursement amounts, some claims administrators embody the major issues plaguing the California workers' compen...
May 18, 2023
CA Makes Treating Injured Workers Unsustainable
Why are doctors unwilling to treat injured workers?In California, injured workers often struggle to find doctors willing to provide treatment. The main reason for this...