California Workers' Comp
Sep 10, 2018
CA: Location-Based Adjustments Set to Take Effect in 2019
In April, the California Division of Workers’ Compensation (DWC) held a hearing regarding the inclusion of the Medicare Geographic Practice Cost Indices (GPCI) in the Physici...
Sep 7, 2018
CA Claims Admins Fail to Comply With IBR Rules
When the Independent Bill Review (IBR) process overturns a claims administrator’s incorrect denial or adjustment, the claims administrator is legally bound to timely pay what...
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Sep 6, 2018
CA Pathology/Clinical Laboratory Billing: NCCI Edits Do Not Apply
Medicare’s National Correct Coding Initiative (NCCI) complicates California workers’ comp billing, to say the least. NCCI edits are the source of much confusion, as pr...
Aug 24, 2018
Broadspire Denies Unprocessed Workers’ Comp Bills
Broadspire, a global third-party claims administrator (TPA), incorrectly denied several bills for the treatment of an injured worker. While incorrect denials are nothing new ...
Aug 23, 2018
CA Workers' Comp: Navigating Billing for Allianz/FFIC
Effective May 1 of this year, insurers Allianz and Fireman’s Fund Insurance Company (FFIC) merged their payment systems for California workers’ comp to reflect Allianz’s 2015...
Aug 10, 2018
Maximus Creates IBR Delays With Impossible Demands
Maximus Federal Services, the private entity which conducts Independent Bill Review (IBR) on behalf of California’s Division of Workers’ Compensation (DWC), has always demons...
Aug 9, 2018
Clearinghouses Under the Microscope: StoneRiver P2P
Most claims administrators lack the technology to process electronic bills from providers. Instead, these claims administrators rely on clearinghouses. Since DaisyBill has di...
Aug 8, 2018
CA Providers: Do Not Provide Additional Reports Without Payment
For California workers’ comp providers, reporting is an important (if sometimes burdensome) requirement. Documentation is everything, hence the requirements for reports like ...
Aug 3, 2018
CA DWC Revises OMFS Update, Resolves MUE/Acupuncture Confusion
A recently adopted Medicare Medically Unlikely Edit (MUE) assigned a value of “0” to many common workers’ comp billing codes, including those for acupuncture services. Provid...
Aug 2, 2018
Details Matter: Always Keep Accurate Workers' Comp Bill History
When it comes to protecting your office’s revenue, maintaining detailed and accurate records is crucial. Especially when disputes over billing and payment arise, it’s often t...
Aug 1, 2018
OMFS Update: Reimbursement Change For Pathology and Clinical Laboratory Services
California’s Division of Workers’ Compensation (DWC) ordered an update to the Pathology and Clinical Laboratory section of the Official Medical Fee Schedule, bringing the OMF...
Jul 27, 2018
Get Ready: WHO Releases Expanded, Electronic ICD-11
The World Health Organization (WHO) released an initial version of its 11th International Classification of Diseases and Related Health Problems (ICD-11). Vastly larger than ...