California DWC
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...
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...
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 ...
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...
Jul 13, 2021
CA Workers' Comp Q&A Highlights
We asked our readers to submit their most vital California workers’ comp questions for a live Q&A webinar. They did not disappoint!If you missed it, below is a brief r...
Jul 12, 2021
Sedgwick Denies Second Review Appeals as "Duplicates"
Sedgwick has a Second Review problem.On too many occasions, Sedgwick incorrectly denies providers’ Second Review appeals as “duplicate submissions” of the original bil...
Jul 5, 2021
OMFS Update: 59 Codes Newly Billable
California’s Division of Workers’ Compensation (DWC) issued an update to the Physician and Non-Physician Practitioner portion of the Official Medical Fee Schedule (OMFS) for ...
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May 20, 2021
MPNs: The Jekyll and Hyde of Workers' Comp
We’ve argued that MPNs are mostly a drag on the workers’ compensation system. But as some employers demonstrate, they don’t have to be.When employers use MPNs to maint...
May 19, 2021
Anthem: PPO Discount Payments BELOW Medicare
Q: How much can a workers’ comp provider lose by signing a Preferred Provider Organization (PPO) agreement?A: Much, much more than the provider probably realizes.
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 5, 2021
City and County of San Francisco's Misleading Response in PPO Discount Dispute
Recently, a DaisyBill provider disputed a reduction in reimbursement from the City and County of San Francisco (CCSF) for treating an injured employee. In the Explanation of ...
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...