California Workers' Comp
An Open Letter to Sedgwick Claims Management Services, Inc.
Sep 26, 2022
An Open Letter to Sedgwick Claims Management Services, Inc.
Dear Sedgwick Claims Management Services,This is a plea. In all sincerity, and all snark aside, California workers, providers, and employers need you to do bett...
ALERT! AIG Moving All Claims to Gallagher Bassett
Sep 15, 2022
ALERT! AIG Moving All Claims to Gallagher Bassett
Important update for providers: Third-Party Administrator (TPA) AIG Claims, Inc. will no longer administer workers’ comp claims. All claims currently administered by A...
Berkshire Hathaway Repairs Electronic EOR Issue
Sep 15, 2022
Berkshire Hathaway Repairs Electronic EOR Issue
There’s no excuse for claims administrators not to accept and properly process electronic bills, a legal requirement in California for almost 10 years now. Ever...
AmTrust Addresses Electronic EOR Issue
Sep 15, 2022
AmTrust Addresses Electronic EOR Issue
Insurer AmTrust North America provided an excellent example of how claims administrators, working in good faith with providers, can resolve Electronic Data Interchange (EDI) ...
CA SCIF Baits & Switches MD Out of Payment
Sep 7, 2022
CA SCIF Baits & Switches MD Out of Payment
Once again, California’s State Compensation Insurance Fund (SCIF) may profit by exploiting a flaw in California’s Independent Bill Review (IBR) system.SCIF initially d...
ESIS Pays Med-Legal Bills Following Audit Complaints
Sep 7, 2022
ESIS Pays Med-Legal Bills Following Audit Complaints
California physicians can always rely on ESIS to pay its bills for Medical-Legal services — as long as they're willing to report ESIS to the Division of Workers’ Compensation...
IBR: Sedgwick Ordered to Pay QME $20k+ for False Med-Legal Denial
Sep 7, 2022
IBR: Sedgwick Ordered to Pay QME $20k+ for False Med-Legal Denial
Sedgwick Claims Management Services just set a dubious new record. Maximus, the entity which conducts Independent Bill Review (IBR) on behalf of California’s Division of Work...
Adminsure (Promptly) Fixes EOR Glitch
Sep 7, 2022
Adminsure (Promptly) Fixes EOR Glitch
Third-Party Administrator (TPA) Adminsure recently offered a perfect example of how workers’ comp can work beautifully when claims administrators take their responsibilities ...
LWP Refuses to Pay e-Bills, Forcing CA Doctors to Fax Bills
Aug 18, 2022
LWP Refuses to Pay e-Bills, Forcing CA Doctors to Fax Bills
California workers’ comp law has precise, mandatory requirements for electronic bill submission by providers, and precise, mandatory requirements for how payers must respond ...
LWP: 7,112 Audit Complaints to Report  Abject e-Billing Failure
Aug 18, 2022
LWP: 7,112 Audit Complaints to Report Abject e-Billing Failure
LWP Claims Solutions can’t seem to find the will or the way to comply with California workers’ comp law, which requires LWP to properly accept and pay electronic bills submit...
Employers Beware: LWP Is a Bad Look
Aug 18, 2022
Employers Beware: LWP Is a Bad Look
Most California self-insured employers utilize a Third-Party Administrator (TPA) to handle injured workers’ claims on their behalf. But not all TPAs are equally competent in ...
LWP Invalid 277 ACKs: False 'Claim Not Found' Rejects - 851 Audit Complaints
Aug 18, 2022
LWP Invalid 277 ACKs: False 'Claim Not Found' Rejects - 851 Audit Complaints
Third-Party Administrator (TPA) LWP Claims Solutions is in violation of California workers’ comp e-billing law. LWP’s persistent failure to honor state requirements places an...