California Workers' Comp

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, ...

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...

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. <...

Discount Dangers: The CA Provider’s Bill of Rights (Right V)

Discount Dangers is a DaisyBill series on the ways some discount contracts unscrupulously reduce providers’ reimbursements. With this series we shine a light on the worst pra...

TPA Change: JCPenney Switches Third-Party Administrator

JCPenney no longer utilizes third-party claims administrator Sedgwick Claims Management Services. The retail department store chain transferred all claims to AIG Claims, Inc....

FYI: American Airlines Changes Bill Review

Self-insured employer American Airlines no longer utilizes Genex Services Bill Review. Effective February 1, 2018, American switched to Sedgwick Claims Management Services Na...

Outpatient/ASC Fee Schedule: DWC Issues (Then Corrects) Reimbursements

The California Division of Workers’ Compensation (DWC) ordered new adjustments to the Official Medical Fee Schedule (OMFS), effective March 15, 2018. The orders update fees f...

How Workers’ Comp Payments By Credit Card Hurt CA Providers

Accepting credit cards from patients for co-pays and deductibles is one thing, but it makes zero financial sense for California providers to accept credit card payments from ...

Complete 2018 Automatic Authorization Guide for California Workers’ Comp

Over the last several months, we blogged extensively (and hosted a free comprehensive webinar) on the new automatic authorization process for California workers’ comp. Here, ...

Discount Dangers: The Provider’s Bill of Rights (Rights III and IV)

Discount Dangers is a daisyBill series on the ways discount contracts incorrectly reduce providers’ reimbursements. With this series, we shine a light on the worst discount p...

CPT 97750 for Functional Capacity Exams: Medically Unlikely Edits

Providers sometimes run into trouble when billing Current Procedural Terminology (CPT) Code 97750. Providers use this procedure code to bill for functional capacity exams, in...

FYI: $10k of Treatment Authorized Before Claim is Accepted or Denied

When an employee files a workers’ compensation claim, the employer or insurer is immediately liable for the cost of all medically necessary treatment provided before the clai...