California Workers' Comp
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...
Oct 9, 2024
Payers Deny 48% of CA Physician's Bills
Attention California providers: it is extremely difficult to obtain reimbursement when you treat or provide services to an injured worker, because the Division of Work...
Oct 3, 2024
Travelers Defies IBR, Shorts CA QME
How many ways can an insurer violate workers’ comp payment laws, regulations, and rules on a single bill?Travelers may have set the benchmark by refusing to correctly ...
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Oct 2, 2024
CA CHSWC Meeting Offers Hope for Workers
California’s Commission on Health and Safety and Workers’ Compensation (CHSWC) held a public meeting on Friday, September 27, 2024. daisyBill representatives attended,...
Oct 1, 2024
CA OMFS Update: Physician Services (Q4 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 ...
Sep 26, 2024
CA Governor Vetoes UR Bill
California Governor Gavin Newsom vetoed California Senate Bill 636, which would have required that Utilization Review (UR) for private employers be conducted only by Californ...