California Workers' Comp
Apr 19, 2018
Audit Complaints Show Workers’ Comp Providers Face Uphill Battle
In California, workers’ compensation providers face a labyrinth of billing and payment rules, and these providers struggle with an enforcement structure that favors employers...
Apr 13, 2018
“By Report” Billing Codes: Best Practices for Proper Reimbursement
When the Official Medical Fee Schedule (OMFS) assigns the reimbursement for a procedure code as “By Report” (BR), establishing the correct payment amount is one of the tricki...
Apr 10, 2018
DIR Director Baker Makes Surprise Retirement Announcement
Christine Baker, Director of California’s Department of Industrial Relations (DIR), unexpectedly announced her retirement on Friday, March 30. With no immediately apparent re...
Apr 9, 2018
Ambulatory Surgical Center (ASC) Billing for CA Workers’ Comp Now Available
Institutional billing for California workers’ comp can be a real pain in the ASC. We just made it a whole lot easier. After exhaustive research, hours of programming, ...
Apr 6, 2018
Interpreter Fee Schedule: An Imperfect Step in the Right Direction
California’s Division of Workers’ Compensation (DWC) proposed new interpreter fee schedule regulations this week. The changes would create a uniform fee schedule, replacing t...
Apr 5, 2018
WCAB Resolves Lien Deadline Issue
Lien claimants who filed required supplemental lien declarations on July 2 or 3 of 2017 wondered: would the Workers’ Compensation Appeals Board (WCAB) agree to adjudicate tho...
Apr 4, 2018
CA Physician Fee Schedule Update Adds New Billing Codes, NCCI Edits
A new order from the Administrative Director of California’s Division of Workers’ Compensation (DWC) updates the Physician and Non-physician practitioner services portion of ...
Mar 30, 2018
Location-Based Reimbursement in CA? DWC Plans Hearing on OMFS Changes
California workers’ comp providers may soon face another layer of complexity in calculating reimbursements: Geographic Practice Cost Indices (GPCI), which would raise or lowe...
Mar 29, 2018
“Secret Settlements” - Double Standard for IMR Rules
Since the introduction of Independent Medical Review (IMR), claims administrators working on behalf of employers and insurers haven’t always played fair. In seeking to uphold...
Mar 28, 2018
PR-2 Report Made Easier: Fillable and Downloadable PR-2 Report Form
Last month, we highlighted the importance of the Treating Physician’s Progress Report, which providers must use to document services rendered. This crucial bit of paperwork, ...
Mar 23, 2018
Automatic Authorization: Late Bill Submission Does Not Bar Payment
Workers’ comp providers, be warned: payors are incorrectly denying bills for automatically authorized services due to untimely submission.Untimely submission is not gr...
Mar 22, 2018
Macy’s Changes Bill Review; Sedgwick Error Causes Bill Rejections
Self-insured employer Macy’s no longer utilizes EK Health Bill Review. Effective March 3, 2018, Macy’s switched to Sedgwick Claims Management Services National Bill Review. <...