California Workers' Comp
Sep 5, 2025
CA Employers Beware: Problems With WCIRB Reports
In its 2025 State of the System report, the Workers’ Compensation Insurance Rating Bureau (WCIRB) presents its findings with an air of authority. However, a close look...
Sep 4, 2025
Careworks Hurts Employers, Providers, and Payers
Employers buy workers’ comp insurance expecting their premium dollars to pay for their injured employees’ treatment. Providers expect timely, accurate payment for treating in...
Aug 25, 2025
MD to ESIS: Remove Us From Your MPN
A California provider will no longer treat injured workers if ESIS, Inc. is the claims administrator.The provider apparently concluded that membership in the Third-Par...
Aug 22, 2025
Zurich: Vague Authorization Creates More Treatment Friction
Insurer Zurich North America offered a classic example of the bureaucratic absurdity that plagues California’s treatment authorization process, issuing a baffling, time-bound...
Aug 19, 2025
CA DWC Ignores Law and Leaves Ortho Practice Unpaid
In California, when a provider pays $195 to request Independent Bill Review (IBR) to dispute an incorrect payment, the California Division of Workers’ Compensation (CA DWC) h...
Aug 15, 2025
Sedgwick Stiffs QME With “Denial Dump” EOR
Sedgwick Claims Management Services, Inc. is raking in profits one unpaid bill at a time through non-compliance, invalid denial reasoning, ...
Aug 14, 2025
e-Billing Data: Worst Payer EDI Grades
Yesterday, we praised the insurers, employers, and Third-Party Administrators (TPAs) that accept and properly process electronic bills (e-bills) with near-perfect consistency...
.gif)
Aug 12, 2025
CA DWC: Routinely Violating IBR Law - Failing to Protect Doctors
Statewide records show that the California Division of Workers’ Compensation (CA DWC) routinely and brazenly violates a critical law legislators put in place to protect provi...
Aug 11, 2025
CA: “Unlisted" Codes - Same Old Blame-the-Thieving-Doctor Trope
To understand what truly drives workers’ comp costs, California must stop relying on insurer-produced “research” that misleads employers and scapegoats doctors.Califor...
Aug 8, 2025
Hyatt: Gallagher Bassett Stiffs Provider With "Denial Dump" EOR
Why provide one baseless, nonsensical reason for refusing to pay a provider when you can provide 10? That’s the approach Gallagher Bassett took when it improperly deni...
Aug 5, 2025
WCIRB’s Flawed Data Means Higher Premiums for CA Employers
Insurers control the narrative around California’s workers’ compensation—and it’s costing the state’s employers more every year.Annually, the Workers’ Compensation Ins...
Aug 4, 2025
Sedgwick’s Shell Game? 139 CA Employers Exposed
A California workers’ comp physician recently received eight checks totaling $110,858 from Careworks, a vendor affiliated with Third-Party Administrator (TPA) Sedgwick.