California DWC

JT2 Plays IBR Chicken (and Wins)
Dec 6, 2021
JT2 Plays IBR Chicken (and Wins)
As we often point out, it can seem as if payers play a twisted game of IBR Chicken with doctors, reflexively denying bills and Second Review appeals only to change their mind...
10 Ways to Fix CA Workers' Comp
Nov 30, 2021
10 Ways to Fix CA Workers' Comp
Today, the California Division of Workers’ Compensation (DWC) will host a virtual public meeting “to hear ideas to improve the efficiency and quality of care provided to inju...
Lien Chaos Returns: DWC Rules for Anthem (Part III)
Nov 17, 2021
Lien Chaos Returns: DWC Rules for Anthem (Part III)
California’s Division of Workers’ Compensation (DWC) has a duplicity problem. In the third chapter of our series on The Zenith and Anthem Blue Cross, we discover that ...
Zurich Refuses to Pay for Emergency Treatment
Oct 14, 2021
Zurich Refuses to Pay for Emergency Treatment
In a medical emergency, a doctor treats first and asks questions later. But in response to a medical emergency, Zurich refused to pay a doctor for suturing a lacerated finger...
CA Med-Legal Reporting Deadline Extension Official
Oct 6, 2021
CA Med-Legal Reporting Deadline Extension Official
California’s Division of Workers’ Compensation (DWC) has officially extended emergency regulations which add 15 days to the usual time frame for Medical-Legal reporting.<...
Pasadena Is (Still) Violating CA Workers' Comp Law
Sep 27, 2021
Pasadena Is (Still) Violating CA Workers' Comp Law
As costs skyrocket, physicians flee the system, and injured workers find it harder and harder to find a doctor willing to treat them, California workers’ comp has yet to reck...
MLFS Billing Tip: CA Med-Legal Deadlines Extended
Sep 23, 2021
MLFS Billing Tip: CA Med-Legal Deadlines Extended
As providers continue to grapple with COVID-19’s impact on healthcare systems, California Medical-Legal examiners (and workers’ comp claims administrators) are reminded: the ...
Liberty Mutual Stiffs QME - Attorneys Required
Sep 22, 2021
Liberty Mutual Stiffs QME - Attorneys Required
Hello California Workers’ Comp Attorneys,  Medical-Legal physicians in this state need your help. Payers like Liberty Mutual have found a way to skirt the Independent ...
Dollar Tree/Sedgwick Won’t Pay for Authorized Treatment
Sep 21, 2021
Dollar Tree/Sedgwick Won’t Pay for Authorized Treatment
Authorization is, by definition, a promise.It’s the promise that, once a doctor obtains authorization from an employer to treat an injured worker, the employer will pa...
CA Cheat Sheet: Required Reports & Supporting Documentation for Workers' Comp Bills
Aug 19, 2021
CA Cheat Sheet: Required Reports & Supporting Documentation for Workers' Comp Bills
In California, when submitting a bill for treating an injured worker, it’s imperative to include the correct documentation to support the treatment. If the provider fails to ...
Audit Complaint: PacificComp Fails to Process e-Bills
Aug 4, 2021
Audit Complaint: PacificComp Fails to Process e-Bills
In California workers’ comp, a provider’s failure to adhere to the billing regulations allows the payer to refuse payment for treatment of the injured worker. But all too oft...
Sedgwick Violates LACoFD Employer Contract, IBR Drops Ball
Jul 15, 2021
Sedgwick Violates LACoFD Employer Contract, IBR Drops Ball
A physician agreed to serve as Independent Medical Examiner (IME) for the Labor Management Committee (LMC) representing the Los Angeles County Fire Department (LACoFD) and Lo...