california division of workers' compensation
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...
Apr 23, 2018
Filter and Search CA MTUS Drug Formulary With New Tool
California’s new drug formulary isn’t exactly user-friendly. For that reason, we developed a new tool to make authorization for pharmaceuticals much, much easier. The ...
Apr 19, 2018
Audit Complaints Show Workers’ Comp Providers Face Uphill Battle
In California, workers’ compensation providers face a labyrinth of billing and payment rules, and these providers struggle with an enforcement structure that favors employers...
Apr 10, 2018
DIR Director Baker Makes Surprise Retirement Announcement
Christine Baker, Director of California’s Department of Industrial Relations (DIR), unexpectedly announced her retirement on Friday, March 30. With no immediately apparent re...
Mar 30, 2018
Location-Based Reimbursement in CA? DWC Plans Hearing on OMFS Changes
California workers’ comp providers may soon face another layer of complexity in calculating reimbursements: Geographic Practice Cost Indices (GPCI), which would raise or lowe...
Mar 29, 2018
“Secret Settlements” - Double Standard for IMR Rules
Since the introduction of Independent Medical Review (IMR), claims administrators working on behalf of employers and insurers haven’t always played fair. In seeking to uphold...