California Workers' Comp

SCIF Inept UR #5: EK Health Ignores MTUS, Denies Surgery
Sep 27, 2023
SCIF Inept UR #5: EK Health Ignores MTUS, Denies Surgery
Why is it so difficult to get treatment for a work-related injury? At least in California, most of the answer is a broken UR system that allows insurers to withhold potential...
ProPublica/NPR: Fees & Discounts Gutting Provider Revenue
Sep 26, 2023
ProPublica/NPR: Fees & Discounts Gutting Provider Revenue
ProPublica and NPR recently published an exposé on entities that impose fees on doctors who accept electronic funds transfer (EFT) payments. These fees c...
daisyBill Account Analytics: Appeal Payments!
Sep 19, 2023
daisyBill Account Analytics: Appeal Payments!
If no one tracks your workers’ comp bills, you’re probably missing critically important information about your practice’s revenue.The sad fact is that between i...
SCIF Inept UR #4: IMR Rules Favor Insurers
Sep 15, 2023
SCIF Inept UR #4: IMR Rules Favor Insurers
In recent articles, we’ve shared the details of State Compensation Insurance Fund (SCIF)’s denial of continued care for an injured worker on false grounds, and ...
FYI: Inaccurate DWC IBR Form May Cost Your Practice
Sep 14, 2023
FYI: Inaccurate DWC IBR Form May Cost Your Practice
California’s Division of Workers’ Compensation (DWC) has strict and specific requirements for providers who wish to dispute incorrect payment amounts through Independent Bill...
SCIF Inept UR #3: IMR Offers No Hope for Injured Worker
Sep 13, 2023
SCIF Inept UR #3: IMR Offers No Hope for Injured Worker
In California workers’ comp, the insurer has the final say over an injured worker's medical care.So what if the insurer gets it wrong? What if the insurer denies appro...
SCIF Inept UR #2: Bungled Medical Records Strikes Again
Sep 12, 2023
SCIF Inept UR #2: Bungled Medical Records Strikes Again
Once again, the consequences of inept Utilization Review (UR) fall on an injured worker.EK Health, conducting UR on behalf of State Compensation I...
UR: An Open Letter to CA Residents
Sep 11, 2023
UR: An Open Letter to CA Residents
Dear California Readers,One of your neighbors experienced a significant head injury while repairing California highways. This individual has diminished cognitive abili...
daisyBill Account Analytics: EOR Count & Source Report
Sep 7, 2023
daisyBill Account Analytics: EOR Count & Source Report
If no one is tracking your workers’ comp bills, you’re probably missing something critically important to your practice’s revenue.The sad fact is, between impro...
SCIF: Inept Utilization Review Delays Care for Injured Worker
Sep 6, 2023
SCIF: Inept Utilization Review Delays Care for Injured Worker
We write often about the systemic issues surrounding Utilization Review (UR) in California and the constant struggle of providers to obtain authorization to tre...
Sedgwick Roundup: TPA Remains Non-Compliant
Aug 25, 2023
Sedgwick Roundup: TPA Remains Non-Compliant
We write a lot here and elsewhere about California’s failure to adequately enforce workers’ comp payment laws and regulations. This failure has created an environment that’s ...
Account Analytics: Average Days to Payment
Aug 23, 2023
Account Analytics: Average Days to Payment
If no one tracks payment analytics for your workers’ comp bills, you’re probably missing critical information about your practice’s revenue from treating injured workers....