South San Francisco, Marin County Change TPAs
Aug 23, 2019
Two municipal employers in California switched third-party administrators (TPAs). Both the City of South San Francisco and the County of Marin transferred claims from TriStar...
SCIF, CorVel IBR Withdrawal Requests Create ENORMOUS Hassles for Providers
Aug 16, 2019
The billing lesson for today: providers should never agree to withdraw a request for Independent Bill Review (IBR), no matter how sweetly the payor begs. Trust us; we’ve lear...
Select Staffing: Changes TPA and Claim Numbers
Aug 15, 2019
Attention California providers: Select Staffing no longer uses CorVel as its Third-Party Administrator (TPA).Effective July 1, 2019, Broadspire administers all claims ...
Blatant Disregard for IBR Law by Sedgwick, Gallagher, Athens, Helmsman
Aug 5, 2019
A disturbing pattern is emerging from the results of Independent Bill Review (IBR) decisions in the state of California. As usual, the problem encumbers workers’ comp provide...
Berkshire Hathaway Fails to Process Second Review Appeals
Aug 1, 2019
Berkshire Hathaway Homestate Companies (BHHC) is failing to process electronic second review appeals, leaving providers in an unacceptable payment limbo. The insurer incorrec...
Costco, Home Depot, & Other Employers Should Be Mad as HEL*
Jul 29, 2019
Recently a provider shared a letter, apparently meant to intimidate, that it received from a Liberty Mutual Network Specialist, Peter Spalding. The letter threatened to kick ...
Mitchell Unresolved EOR Mess
Jul 17, 2019
A persistent glitch in Mitchell’s bill review service is causing revenue management chaos for providers. For second review appeals, providers receive electronic explanations ...
TPA Change Alert: LA County Switches Claims Administrators
Jul 11, 2019
Effective July 1, 2019, the County of Los Angeles is no longer utilizing third-party claims administrator (TPA) TriStar Risk Management. Claims are transferred to eith...
CA OMFS: DMEPOS Fee Schedule Update Effective 7/1/ 2019
Jul 10, 2019
In Newsline No.: 2019-53, the California Division of Workers’ Compensation (DWC) announced updates to the Official Medical Fee Schedule for Durable Medical Equipment, Prosthe...
CA OMFS Update: Pathology/Clinical Lab Fee Schedule for 7/1/2019
Jul 9, 2019
On July 8, 2019, California’s Division of Workers’ Compensation (DWC) ordered an update to the Pathology and Clinical Laboratory section of the Official Medical Fee Schedule ...
Magna Carta - Bills Not Processed
Jul 8, 2019
Providers, be aware that Magna Carta Companies (formerly PSM) ended its relationship with its bill review service, CorVel. More importantly, Magna Carta is not responding to ...
Claims Admins Deny Second Review Appeals as Duplicate Bills
Jul 2, 2019
Two claims administrators, York and Sedgwick, denied hundreds of compliant second review appeals on the grounds that the appeals were “duplicates” of the Original Bills in qu...