CA Workers' Comp Q&A Highlights
Jul 13, 2021
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...
Sedgwick Denies Second Review Appeals as "Duplicates"
Jul 12, 2021
Sedgwick has a Second Review problem.On too many occasions, Sedgwick incorrectly denies providers’ Second Review appeals as “duplicate submissions” of the original bil...
OMFS Update: 59 Codes Newly Billable
Jul 5, 2021
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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MPNs: The Jekyll and Hyde of Workers' Comp
May 20, 2021
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...
Anthem: PPO Discounts Result in Payments BELOW Medicare
May 19, 2021
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.
CNA Repeatedly Ignores California Law
May 12, 2021
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...
City and County of San Francisco's Misleading Response in PPO Discount Dispute
Apr 5, 2021
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 ...
Broadspire Knows No Law But Its Own
Apr 2, 2021
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...
New CA Med-Legal Fee Schedule Effective April 1
Mar 31, 2021
California’s Office of Administrative Law (OAL) issued final approval of the revamped Medical-Legal Fee Schedule (MLFS) for workers’ compensation, effective for dates of serv...
CA OMFS: Physician Fee Schedule Update Effective April 1
Mar 29, 2021
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 ...
Zurich Delays Telehealth Reimbursement During Pandemic
Mar 26, 2021
Zurich seems committed to a policy of improperly denying reimbursement for telehealth services, during a pandemic in which remote treatment is crucial to maintaining care for...
How to Apply HCPCS G2212 in CA Workers' Comp
Mar 15, 2021
Important Update: The DWC adopted an MUE limiting the number of units of G2212 providers may bill. Details below!This year, California’s Division of Workers’ Compensat...