California Workers' Comp

CA Workers' Comp: Broken by Design?
Jul 25, 2024
CA Workers' Comp: Broken by Design?
In response to our recent report on new, burdensome regulatory changes proposed by California’s Division of Workers’ Compensation (DWC), a California provider sent us an impa...
LA Metro Transit Authority: 12,879 Audit Complaints Filed
Jul 17, 2024
LA Metro Transit Authority: 12,879 Audit Complaints Filed
The Los Angeles County Metropolitan Transit Authority (LA Metro), a public self-insured employer, fails to fulfill one of its most basic (but essential) legal obligations to ...
DWC's Updated IBR Form - F Is for Fail
Jul 16, 2024
DWC's Updated IBR Form - F Is for Fail
California’s Division of Workers’ Compensation (DWC) recently updated Form IBR-1, which providers use to request an Independent Bill Review (IBR)—but did so without publicizi...
CA: Orthopedist Bill Denial Rates by Claims Admin - Part 3
Jul 12, 2024
CA: Orthopedist Bill Denial Rates by Claims Admin - Part 3
In the firsttwo of this series (read here and here), daisyData from orthopedic surgeon clients highlights how California’s convoluted Medical Provider Ne...
CA: Orthopedist Payment Data by Claims Admin - Part 2
Jul 11, 2024
CA: Orthopedist Payment Data by Claims Admin - Part 2
While all providers who agree to treat injured workers are essential, in this series, daisyBill focuses on orthopedic reimbursement to expose how California’s Medical Provide...
CA: Orthopedists Payment Data - Part 1
Jul 10, 2024
CA: Orthopedists Payment Data - Part 1
Orthopedic providers are vital to workers’ compensation. daisyData reveals that since January 1, 2022, Preferred Provider Organization (PPO) entities have diverted over $18 m...
Sedgwick Stiffs AME for IBR Filing Fee
Jul 2, 2024
Sedgwick Stiffs AME for IBR Filing Fee
In California, when Independent Bill Review (IBR) overturns a Sedgwick erroneous reimbursement denial, Sedgwick owes the provider $180 (the cost of the f...
CA OMFS Update: Physician Services (Q3 2024)
Jul 1, 2024
CA OMFS Update: Physician Services (Q3 2024)
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 ...
Anthem's THM Network Closes, Stiffs Providers
Jun 28, 2024
Anthem's THM Network Closes, Stiffs Providers
Workers’ comp providers—in particular ancillary providers like physical therapists (PTs)—take note: if you have treated injured workers through Anthem’s Transparent Health Ma...
CCSF Sends Corrected Payments to Providers
Jun 26, 2024
CCSF Sends Corrected Payments to Providers
No one knows better than daisyBill how much payment abuse California workers’ comp providers endure.This is why our hearts blossom when claims administrators and their...
Zurich - An Example of California's MPN Shell Game
Jun 25, 2024
Zurich - An Example of California's MPN Shell Game
Where opacity and obfuscation reign, injustice thrives. There may be no better example of this than California’s Medical Provider Network (MPN) system. T...
99¢ Stores: Athens Halts Processing Bills
Jun 20, 2024
99¢ Stores: Athens Halts Processing Bills
In April of this year, 99 Cents Only Stores LLC declared bankruptcy, leaving the self-insured employer with no way to pay its Third-Party Administrator (TPA), Athens Administ...