bill review

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...

accūrō Solutions: Proactive Bill Review Improves Compliance for Payers

It’s not all bad news in the world of workers’ comp billing. While daisyNews regularly holds payers and their vendors accountable for their failures, some companies de...

Genex Claims Marriott Doesn’t Accept e-Bills (It Does)

In California (and increasingly elsewhere), state law requires workers’ comp payers to accept providers’ electronic bills (e-bills) for the treatment of injured worker...

CA: Business Insider Falls for Insurer Propaganda

Business Insider published a cringy slop of insurer talking points, uncritically parroting insurers’ preferred narrative about the coming increase...

Walmart to Change Clearinghouse & Bill Review

Currently, Walmart conducts its bill review internally and directs providers to send electronic bills (e-bills) to clearinghouse vendor Data Dimensions. However, starting...

acūrrō Reprocesses Underpaid CA Bills

Sometimes, seeking correct reimbursement for treating injured workers doesn’t require a battle between providers and payers. Claims administrators and their vendors ca...

CopperPoint Switches Bill Review

CopperPoint Mutual, a workers’ comp insurer that self-administers its claims, changed its bill review vendor to CorVel. The change is effective fo...

Claims Admin Directory - New Free Resource!

Knowledge is power, and sunshine is the best disinfectant. Nowhere are these principles more true than in workers’ compensation, where for too long a convoluted, opaqu...

San Francisco Changes Bill Review, e-Bill Resubmissions Required

Starting February 28, 2022, Allied Managed Care replaces EK Health as the bill review vendor for the City and County of San Francisco (CCSF). Accordingly, providers must subm...

City of Pasadena: CompIQ Saves the Day

Following a switch to a new third-party claims administrator (TPA), the City of Pasadena violated California law by suddenly failing to accept electronic bills for the treatm...

Provider Warning: Prime Health Services (Part I)

Recently, a provider made the unfortunate mistake of signing a Prime Health Services (PHS) Preferred Provider Agreement contract, commonly known as a PPO agreement. While not...

Bill Review Highlight: Definiti Healthcare Management

Over the last several years, providers have sent over 5.2 million workers’ comp bills from daisyBill. These millions of bills allow daisyBill to directly witness the manageme...