California Workers' Comp
Dec 18, 2024
CA: San Bernardino (Finally) Accepts e-Bills
Since 2012, in California, it has been mandatory for workers’ comp claims administrators to accept electronic bills (e-bills) from providers for the treatment of injured work...
Dec 17, 2024
Applied Underwriters: Appalling Treatment Denial
California’s authorization and Utilization Review (UR) system for workers’ comp treatment is profoundly broken—and injured workers are suffering as a result.For the la...
Dec 16, 2024
Sedgwick's Sloppy EDI Tech Goes Haywire
Sedgwick Claims Management, Inc. is daisyBill’s largest workers’ comp claims administrator, as measured by the volume of bills our clients send to the Third-Party Admi...
Nov 18, 2024
New! Networks Listed in Workers' Comp Directory
Since 2022, daisyBill has offered free public access to our Claims Administrator Directory, where providers and administrative staff can find critical information on insurers...
Oct 31, 2024
LA Metro Transit Authority: 4,955 Audit Complaints Filed
The Los Angeles County Metropolitan Transit Authority (LA Metro) is making it harder for California doctors to treat its injured employees—and has given no indication of taki...
Oct 29, 2024
CA Alert: ESIS e-Bill Rejections (and What to Do)
Third-party administrator (TPA) ESIS is improperly rejecting valid e-bills from California providers, citing an inexplicable, seemingly random (and definitely non-compliant) ...
Oct 28, 2024
Paduda (Unintentionally) Blasts CA Workers' Comp
A recent edition of Joe Paduda’s Managed Care Matters newsletter absolutely nails the systemic issues that plague California workers’ comp. The only twist? Mr. Paduda wasn’t ...
Oct 23, 2024
DWC Slumbers as Sedgwick Stiffs CA Ortho Practice
Recently, we shared how Sedgwick Claims Management Services repeatedly took inflated Preferred Provider Organization (PPO) discounts from a California orthopedic practice in ...
Oct 22, 2024
Sedgwick Stiffs CA Practice for Over $300,000
In California, claims administrators can siphon staggering amounts of revenue from practices using invalid Preferred Provider Organization (PPO) discounts—and doctors have no...
Oct 16, 2024
Sedgwick Removes 54% UR Denial Stat From Website
We knew it was only a matter of time. The question was how much time?Third-party administrator (TPA) Sedgwick Claims Management Services screamed the quiet part out lo...
Oct 11, 2024
Over 2,500 CA MPNs Vanish (Again)
By now, we’ve grown accustomed to the California Division of Workers’ Compensation (DWC) utterly failing to manage the state’s Medical Provider Network (MPN) sy...
Oct 10, 2024
Medicare Advantage & Workers' Comp: Why Providers Reject Both
Becker’sreports that hospitals and health systems across the nation are giving up on Medicare Advantage, terminating contracts and refusing to treat patients co...