California Workers' Comp
Feb 9, 2023
E/M Data: CPT 99214 Reimbursement 2022
Far too often, California providers are not receiving Official Medical Fee Schedule (OMFS) rates for Evaluation and Management (E/M) for injured workers — as evidenced by our...
Feb 8, 2023
Data: SCIF Pays Medicare Rates for E/M Services
Like The Zenith, California’s State Compensation Insurance Fund (SCIF) consistently pays Medicare rates to doctors for treating injured workers.According to data from ...
Feb 7, 2023
Data: Zenith Pays Medicare Rates for E/M Services
According to data from over 10,000 e-bills submitted for 2022 dates of service via daisyBill, insurer The Zenith paid 76% of the reimbursement rates established by California...
Feb 6, 2023
Anthem PPO Contract Renders OMFS Meaningless
At first glance, recent updates to California’s Official Medical Fee Schedule (OMFS) for workers’ comp may seem like a raise for doctors. By establishing OMFS rates at roughl...
Feb 1, 2023
CA 2022 Data: Claims Admin Days to Payment
The numbers are in! 2022 data prove once again that electronic billing slashes the time it takes for providers to get paid for treating injured workers in California (...
Jan 31, 2023
CA Physician Fee Schedule - 2023 Changes
Yesterday, California’s Division of Workers’ Compensation (DWC) announced reimbursement updates to the Physician and Non-Physician Practitioner Services section...
Jan 30, 2023
Med-Legal IBR Data: A Bad Look for Sedgwick & CA
California appears to turn a willfully blind eye to what seems like an abuse of the Independent Bill Review (IBR) system for Medical-Legal disputes.Data ...
Jan 26, 2023
Forbes Fluff Distorts CA Workers' Comp Realities
The good folks at Forbes recently offered California doctors and injured workers a slap in the face, in the form of a political fantasy narrative thinly veiled as an objectiv...
Jan 24, 2023
CA e-EOR Compliance: 2022 Report Card
Not everything in California workers’ comp is complicated. For example: when a provider chooses to bill electronically for medical services, California regulations req...
Jan 17, 2023
CA EDI Compliance: 2022 e-Billing Report Card
For over ten years, California has had a simple legal requirement: all claims administrators must accept electronic bills from providers for the treatment of injured workers....
Jan 11, 2023
Sedgwick Authorization Sewer - Why CA Needs UR Reform
An injury occurs at work. The injured worker sees a doctor. The doctor concludes that the worker needs a consultation from a specialist. Per California law, the treating doct...
Jan 5, 2023
Tristar: 16,459 Audit Complaints Filed
For all its complexity, California workers’ comp has one very simple law: if a doctor chooses to send bills electronically, the claims administrator must accept that doctor’s...