california division of workers' compensation
Apr 15, 2025
An Open Letter to CHSWC re: UR Abuse (cc: Governor Newsom)
To the Members of the Commission on Health and Safety and Workers’ Compensation (CHSWC)CC: Governor Gavin NewsomRE: California’s Broken Utilization Review Syste...
Mar 27, 2025
Sedgwick’s Abuse of Providers Should Terrify Employers
A question for California employers: If Sedgwick Claims Management Services, Inc. (Sedgwick) treats doctors as poorly as our data reveal, what is the impact on your injured e...
Mar 5, 2025
CA Farce Alert: $300K to Study Nonexistent UR Data
The California Division of Industrial Relations (DIR) has outdone itself in bureaucratic absurdity—proposing to spend $300,000 on a study without any data to study. In...
Feb 24, 2025
CA: IBR Fee Increase - DWC Web Page Lists Wrong Amount
In 2025, California providers must pay more to file for Independent Bill Review (IBR) to dispute improper reimbursements from payers, due to an increased IBR filing fee. ...
Feb 12, 2025
CA OMFS: Additional 2025 Pathology, Clinical Lab Fee Schedule Update
The California Division of Workers’ Compensation (CA DWC) issued an additional update to the Pathology and Clinical Laboratory portion of the Official Medical Fee Schedule (O...
Jul 25, 2023
Sedgwick Must Be Fined: An Open Letter to the CA DWC
To: California Division of Workers’ Compensation (DWC)From: daisyBillSubject: 102,498 Sedgwick Audit ComplaintsWe hope this message finds you well. We wr...
Sep 15, 2022
Data! Top 10 Claims Admins: CA Electronic EOR Compliance
Electronic Explanations of Review (e-EORs) are a non-negotiable requirement of workers’ comp electronic billing. Within 15 working days of receiving a provider’s e-bill, the ...
Jul 22, 2021
Provider Alert: Broadspire Contorts Work First Casualty Claims
Broadspire is the designated third-party administrator (TPA) for Work First Casualty Company, a workers’ comp insurer. While Broadspire normally conducts its own internal bil...
May 12, 2021
CNA Repeatedly Ignores California Law
By law, claims administrators must remit payment for Medical-Legal services within 60 days of receiving the physician’s bill. As of this writing, payment to one physician fro...
Apr 2, 2021
Broadspire Knows No Law But Its Own
Broadspire continues to break the rules, seemingly confident that California regulators will not hold the claims administrator to account. For months, we reported on B...
Apr 2, 2020
Telehealth: Video vs Audio Explained for California Workers' Comp
In our most recent webinar, California Workers’ Comp Telehealth Made Easy, we reviewed the Medicare and California Division of Workers’ Compensation (DWC) rules for providing...
May 2, 2019
SB 537: Say NO to Medicare Reimbursements
A proposed California bill, though seemingly benign, may establish Medicare rates as a standard for workers’ comp reimbursements, which would be a mistake. The bill, w...