California Workers' Comp

CA: Employer Authorization Is Ultimately Worthless

California law mandates that once an employer authorizes treatment for an injured worker, that authorization may not be rescinded “for any reason,” theoretically guaranteeing...

Sedgwick Late e-EORs: 13,999 Audit Complaints Submitted

Sedgwick Claims Management Services is breaking the law. We encourage the California Division of Workers’ Compensation (DWC) to assert its role in upholding workers’ comp law...

Sedgwick Missing e-EORs: 25,970 Audit Complaints Submitted

Sedgwick Claims Management Services is breaking the law. We encourage the California Division of Workers’ Compensation (DWC) to assert its role in upholding workers’ comp law...

Sedgwick: Gruesome and Abusive IBR Games

In California workers’ comp, providers cannot rely on authorization to guarantee payment — despite what the law says. Today’s article shows exactly how a claims administrator...

New! Penalty & Interest Added to Claims Admin Directory

Penalties and interest for untimely paid workers’ comp bills are not well-enforced in California — but daisyBill is keeping score.Our free Claims Administrator Directo...

Hurray! Proposed IBR Changes Benefit Doctors

Proposed legislation in California would allow the state’s Independent Bill Review (IBR) organization (Maximus) to invoice the payer (aka claims administrator) for the review...

CA OMFS: E/M Reimbursement vs Medicare Reimbursement

California workers’ comp allows discount networks to bleed the doctors who treat injured workers. Unfortunately for these workers and their employers, many of these financial...

Broadspire Sends Ludicrous Refund Demand to Doctor

You’ll have to read it to believe it. Third-Party Administrator (TPA) Broadspire sent a perfectly ludicrous letter to a doctor, demanding the doctor refund Broadspire ...

Data: e-Bill 277 Acknowledgement Compliance Rates

To facilitate electronic billing for workers’ comp, California requires claims administrators to confirm receipt of provider e-bills with a standardized electronic acknowledg...

Data: e-EOR Compliance Rates

To facilitate electronic billing for workers’ comp, California requires all claims administrators to respond to provider e-bills with electronic EORs (e-EORs). Within 15 work...

Major e-Bill Failure for Data Dimensions Clients

One hundred claims administrators, all of which use Data Dimensions as their designated clearinghouse, are suddenly failing to comply with California e-billing requirements. ...

Alert: ESIS Fails to Process e-Bills Due to (Their) Document Error

A daisyBill provider client recently brought to our attention systemic e-billing non-compliance by Third-Party Administrator (TPA) ESIS, Inc. Specifically, ESIS denied paymen...