California Workers' Comp
Jan 5, 2018
Authorization: 6 Qualifying Conditions for Fast-track Automatic Authorization
On January 1, 2018, the new “fast-track” automatic authorization takes effect. In certain cases, some providers will be able to provide treatment without first submitting a R...
Jan 4, 2018
FYI: Fresno County Changes TPA
Effective January 1, the employer County of Fresno transferred all claims from third-party administrator (TPA) Risico Claims Management, Inc. to Acclamation Insurance Managem...
Jan 3, 2018
Med-Legal Billing: How to Obtain Reimbursement for Diagnostic Tests
The conditions under which claims administrators must pay medical-legal doctors for diagnostic tests are specific and narrow. To ensure reimbursement, it’s important to know ...
Dec 28, 2017
This Holiday, Remember Who Work Comp Affects
We write a lot about the struggles of workers’ comp professionals. As providers, payors and regulators navigate the deep weeds of rules, codes, conflicts, and everything else...
Dec 23, 2017
2018 Radiology Reimbursements (Professional Services): Cheat Sheet
Lately, we brought readers the Division of Workers’ Compensation (DWC)’s recent updates to the Physician fee schedule for evaluation & management and surgery. Today, we take ...
Dec 20, 2017
2018 Surgery Reimbursements: Cheat Sheet
2018 is around the corner, and the Division of Workers’ Compensation (DWC) recently posted updates to the Official Medical Fee Schedule (OMFS), effective January 1. La...
Dec 19, 2017
Audit Complaints: Work Comp Providers Demanded Compliance in 2017
daisyBill providers stood firm in demanding timely, correct payments in 2017 by using our Audit Complaints* Tool to report payor noncompliance.We always advocate for c...
Dec 15, 2017
2018 E/M and Other Services Cheat Sheet
*Update: The 2021 OMFS updates drastically changed how E/M codes are billed.*It’s that time of year: the DWC recently announced changes to the reimbursem...
Dec 14, 2017
In Workers' Comp, Authorization Is Final
Let’s be very clear: in the workers’ comp dialect of Legalese, “authorization” means guaranteed payment for approved services. Period.While one can imagine scenarios i...
Dec 12, 2017
Provider Alert: California Prescription Drug Formulary Effective January 2018
Last week, California’s Office of Administrative Law approved the Division of Workers’ Compensation (DWC)’s proposed evidence-based drug formulary. Through the formulary, the...
Dec 8, 2017
Medical-Legal Billing Lacks Necessary Rules
When it comes to medical-legal billing, the workers’ comp field is missing something. For medical-legal bills, no rules govern the billing form used or the method used...
Dec 4, 2017
Alert: Patriot National, Inc. and Guarantee Insurance Co. Threatened Collapse
Patriot National Inc., an end-to-end insurance services business that includes third-party administrator Patriot Risk Services, recently defaulted on its debt and laid off ab...