Most Recent Articles
Sep 30, 2015
The #1 Reason for Audit Complaints
In the last 30 days, DaisyBillers submitted over 800 Audit Complaints* to California’s Division of Workers’ Compensation. The pie chart above shows that the number one reason...
Aug 20, 2015
Work Comp Audit Complaints: When Everything Else Fails
What if you’ve done everything correctly and the claims administrator is just not paying your work comp medical bills? Your bills are authorized, complete, compliant, timely,...
Dec 16, 2014
Maximus Independent Bill Review: Incorrectly Denied IBRs
Here at DaisyBill, our goal is to ensure the proper processing of all workers’ comp bills; in particular, that all parties observe the regulations mandated by the DWC. When p...
Mar 8, 2017
SCIF Denying Evaluation and Management Codes
State Compensation Insurance Fund (SCIF) recently unveiled a “new program” with regard to reimbursement for billed Evaluation and Management (E/M) Codes. Per a conversation w...
Aug 16, 2017
DWC Closes Over 292,000 Liens per New Declaration Requirements
The California Division of Workers’ Compensation (DWC) just dismissed your lien if you did not comply with new Supplemental Lien Declaration requirements prescribed by last y...
Jan 10, 2017
DWC Releases New Lien Forms to Comply with SB 1160
At the start of the year, the California Division of Workers’ Compensation (DWC) made good on the lien reforms promised by Senate Bill 1160. Along with the Workers’ Compensat...
Nov 15, 2016
Lien Machine: Mastering the New Lien Declaration in Senate Bill 1160
The ink has dried and the dust is settling – the workers’ comp reforms in Senate Bill 1160 are here to stay. Chances are you’ve heard about these changes by now. SB 11...
Dec 10, 2014
Sedgwick Incorrect Denials of PR-2 Reports
Recently, several clients have reported Sedgwick refusing to pay PR-2 reports when billed with a reimbursable prolonged service code (such as a 99354).In each case, the prima...
Nov 8, 2018
CA Claims Admin Delays Payment, Skirts IBR Rules
When the Independent Bill Review (IBR) process overturns a claims administrator’s incorrect denial or adjustment, the claims administrator is legally bound to timely pay what...
Feb 12, 2019
Maximus Confirms Using Second Review Appeals to Correct Billing Errors
Correcting a coding error is as simple as submitting a Second Review appeal explaining the error. Last year, we discussed the convoluted process to correct billing err...
Feb 19, 2019
IBR Appeal Analysis for CPTs 99358 & 99359
**Update: The 2021 OMFS updates drastically changed how E/M codes are billed.*Reimbursements for CPTs 99358 & 99359 are tricky because payers frequently deny reimburse...
Mar 27, 2019
Second Review Loopholes Hurt Providers
Our previous articles highlighted claims administrators’ processing speed for original bill submissions. Now, we turn our attention to average days to process Second Review a...