Appeals

CCSF Sends Corrected Payments to Providers
Jun 26, 2024
CCSF Sends Corrected Payments to Providers
No one knows better than daisyBill how much payment abuse California workers’ comp providers endure.This is why our hearts blossom when claims administrators and their...
Sedgwick (and the DWC) Ignore Providers' Appeals
Jun 12, 2024
Sedgwick (and the DWC) Ignore Providers' Appeals
Sedgwick is running roughshod over California providers, in violation of state workers’ comp law. By failing to take substantive action, the Division of Workers’ Compe...
Med-Legal Company Collects $1M From Appeals in 2023
Jun 11, 2024
Med-Legal Company Collects $1M From Appeals in 2023
How much money is your practice leaving on the table? daisyData show that in 2023, one California client collected over $1 million from submitting Second...
Sedgwick Denies/Ignores Hundreds of Appeals
Jun 10, 2024
Sedgwick Denies/Ignores Hundreds of Appeals
Sedgwick's persistent failure to pay providers in accordance with state workers' comp fee schedules and its refusal to respond compliantly to providers’ appeals are glaring v...
CA Payment Denial Rates 2024 vs 2023 - Top 20 Claims Administrators
Jun 6, 2024
CA Payment Denial Rates 2024 vs 2023 - Top 20 Claims Administrators
California workers’ comp claims administrators are denying providers’ bills with increasing frequency in 2024 compared to 2023. The data below represent the 20 claims ...
Gallagher Bassett Denies Bill, Spews Nonsense, Ignores Appeal
Jun 5, 2024
Gallagher Bassett Denies Bill, Spews Nonsense, Ignores Appeal
Welcome to California workers’ comp, where a claims administrator’s legal obligation to timely pay providers’ bills is more a matter of theory than practice.Safe from ...
CA Appeals: Sutter Health Pays for Frankenreport
May 31, 2024
CA Appeals: Sutter Health Pays for Frankenreport
In our previous article, daisyNews detailed how Sutter Health authorized a California provider to create a strange combination of a Permanent and Stationary (P&S) report and ...
Costco/Helmsman: Improper $5K Payment Denial
May 8, 2024
Costco/Helmsman: Improper $5K Payment Denial
For California physicians, too much time, effort, and revenue are at stake to accept ludicrous payment denials for Medical-Legal evaluations. Unfortunately, California...
CA Interpreters, Submit Those Second Bill Reviews!
Nov 21, 2023
CA Interpreters, Submit Those Second Bill Reviews!
Many providers of interpreter services in California are forgoing their legal right to correct reimbursement, potentially leaving large amounts of revenue on the table. Becau...