California Workers' Comp

CNA Repeatedly Ignores California Law

By law, claims administrators must remit payment for Medical-Legal services within 60 days of receiving the physician’s bill. As of this writing, payment to one physician fro...

Mob Rule: SCIF/Anthem Hold Patient(s) Hostage

On paper, Medical Provider Networks (MPNs) are a simple workers’ comp quality/cost-control measure. Employers designate an MPN, and injured workers choose from among the MPN ...

2021 CA Med-Legal Billing Codes Pocket Guide

California has a new Medical-Legal Fee Schedule (MLFS), effective April 1. To help medical-legal evaluators and their staff navigate these (drastic) changes, we created a dow...

Broadspire Pays Provider 47% Below CA OMFS

It happens every year: Reimbursement rates for workers’ compensation services in California change, and payers reimburse providers at the lesser, previous rates.It hap...

City & County of San Francisco's Misleading Reply in PPO Dispute

Recently, a DaisyBill provider disputed a reduction in reimbursement from the City and County of San Francisco (CCSF) for treating an injured employee. In the Explanation of ...

Broadspire Knows No Law But Its Own

Broadspire continues to break the rules, seemingly confident that California regulators will not hold the claims administrator to account. For months, we reported on B...

Medical-Legal Cheat Sheet for CA Workers' Comp

It’s official: California workers’ compensation has a new Medical-Legal Fee Schedule (MLFS). The updated MLFS is effective for dates of service on or after April 1, 20...

New CA Med-Legal Fee Schedule Effective April 1

California’s Office of Administrative Law (OAL) issued final approval of the revamped Medical-Legal Fee Schedule (MLFS) for workers’ compensation, effective for dates of serv...

CA: New Med-Legal Fee Schedule Pending

A reimagined Medical-Legal Fee Schedule is on the way.Following the required public hearing and comment period, California’s Division of Workers’ Compensation (DWC) fi...

Zurich Denies Liability After Accepting Liability

Zurich recently denied liability for an injured workers’ treatment, claiming the 2003 injury was not work-related — despite the fact that Zurich already authorized the treatm...

CA OMFS: Physician Fee Schedule Update Effective April 1

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 ...

Zurich Delays Telehealth Reimbursement During Pandemic

Zurich seems committed to a policy of improperly denying reimbursement for telehealth services, during a pandemic in which remote treatment is crucial to maintaining care for...