California Workers' Comp

IBR: Sedgwick Ordered to Pay QME $20k+ for False Med-Legal Denial
Sep 7, 2022
IBR: Sedgwick Ordered to Pay QME $20k+ for False Med-Legal Denial
Sedgwick Claims Management Services just set a dubious new record. Maximus, the entity which conducts Independent Bill Review (IBR) on behalf of California’s Division of Work...
Adminsure (Promptly) Fixes EOR Glitch
Sep 7, 2022
Adminsure (Promptly) Fixes EOR Glitch
Third-Party Administrator (TPA) Adminsure recently offered a perfect example of how workers’ comp can work beautifully when claims administrators take their responsibilities ...
LWP Refuses to Pay e-Bills, Forcing CA Doctors to Fax Bills
Aug 18, 2022
LWP Refuses to Pay e-Bills, Forcing CA Doctors to Fax Bills
California workers’ comp law has precise, mandatory requirements for electronic bill submission by providers, and precise, mandatory requirements for how payers must respond ...
LWP: 7,112 Audit Complaints to Report  Abject e-Billing Failure
Aug 18, 2022
LWP: 7,112 Audit Complaints to Report Abject e-Billing Failure
LWP Claims Solutions can’t seem to find the will or the way to comply with California workers’ comp law, which requires LWP to properly accept and pay electronic bills submit...
Employers Beware: LWP Is a Bad Look
Aug 18, 2022
Employers Beware: LWP Is a Bad Look
Most California self-insured employers utilize a Third-Party Administrator (TPA) to handle injured workers’ claims on their behalf. But not all TPAs are equally competent in ...
LWP Invalid 277 ACKs: False 'Claim Not Found' Rejects - 851 Audit Complaints
Aug 18, 2022
LWP Invalid 277 ACKs: False 'Claim Not Found' Rejects - 851 Audit Complaints
Third-Party Administrator (TPA) LWP Claims Solutions is in violation of California workers’ comp e-billing law. LWP’s persistent failure to honor state requirements places an...
LWP Invalid 277 ACKs: Untimely Reject After Prior Accept - 2,075 Audit Complaints
Aug 18, 2022
LWP Invalid 277 ACKs: Untimely Reject After Prior Accept - 2,075 Audit Complaints
Third-Party Administrator (TPA) LWP Claims Solutions is in violation of California workers’ comp e-billing law. LWP’s persistent failure to honor state requirements places an...
LWP Invalid 277 ACKs: Non-Compliant STC Category-Code Payment Denial - 339 Audit Complaints
Aug 18, 2022
LWP Invalid 277 ACKs: Non-Compliant STC Category-Code Payment Denial - 339 Audit Complaints
Third-Party Administrator (TPA) LWP Claims Solutions is in violation of California workers’ comp e-billing law. LWP’s persistent failure to honor state requirements places an...
LWP Invalid 277 ACKs: Non-Compliant Rejections for Second Review Appeals  - 102 Audit Complaints
Aug 18, 2022
LWP Invalid 277 ACKs: Non-Compliant Rejections for Second Review Appeals - 102 Audit Complaints
Third-Party Administrator (TPA) LWP Claims Solutions is in violation of California workers’ comp e-billing law. LWP’s persistent failure to honor state requirements places an...
LWP Non-Compliant 835 e-EORs: Untimely or Missing - 1,785 Audit Complaints
Aug 18, 2022
LWP Non-Compliant 835 e-EORs: Untimely or Missing - 1,785 Audit Complaints
Third-Party Administrator (TPA) LWP Claims Solutions is in violation of California workers’ comp e-billing law. LWP’s persistent failure to honor state requirements places an...
LWP Non-Compliant 835 e-EORs: Invalid and Unpostable - 1,960 Audit Complaints
Aug 18, 2022
LWP Non-Compliant 835 e-EORs: Invalid and Unpostable - 1,960 Audit Complaints
Third-Party Administrator (TPA) LWP Claims Solutions is in violation of California workers’ comp e-billing law. LWP’s persistent failure to honor state requirements places an...
Provider Alert: Athens Fails to Accept e-Bills
Aug 11, 2022
Provider Alert: Athens Fails to Accept e-Bills
Athens Administrators, a Third-Party Administrator (TPA), is out of compliance with California workers’ comp law.California law mandates claims administrators must acc...