California Workers' Comp
Dec 14, 2022
WCF Falsely Demands QME Refund
A friendly reminder to all California Qualified Medical Evaluators (QMEs) and Agreed Medical Evaluators (AMEs): when a claims administrator demands a refund of reimbursement ...
Dec 14, 2022
Can CA (or Anyone) Trust CareWorks?
CareWorks, a Managed Care Organization (MCO) that offers services such as bill review, utilization review, and “physician network services,” is in legal hot water with the St...
Dec 14, 2022
Sedgwick Missing e-EORs: 31,906 Audit Complaints Submitted
Sedgwick Claims Management Services is breaking the law. We encourage the California Division of Workers’ Compensation (DWC) to assert its role in upholding workers’ comp law...
Dec 8, 2022
2022 Non-Compliance Report: 6 Admins That Fail to Send e-EORs
California workers’ comp switched to electronic billing for very good reasons. e-Billing is much, much faster, wastes far fewer resources, and goes a very long way tow...
Dec 8, 2022
Med-Legal Data: IBR Is the QME/AME's Friend
California workers’ comp presents serious challenges to physicians — and Medical-Legal physicians are no exception. Despite a recently simplified Medical-Legal Fee Sch...
Dec 8, 2022
CA QME Calls Out Cannon Cochran "Abuse and Insults"
A California Qualified Medical Evaluator (QME) has had quite enough nonsensical reimbursement games from Cannon Cochran Management Services, Inc. (CCMSI).The Third-Par...
Dec 8, 2022
Providers Respond: How to Fix CA Workers' Comp
In advance of the public meeting recently held by the Division of Workers’ Compensation (DWC), daisyBill offered a few suggestions for improving California’s workers’ comp sy...
Dec 5, 2022
CA Providers Unite! Suggestions for the DWC
On December 6, 2022, California’s Division of Workers’ Compensation (DWC) invites stakeholders to a public meeting to share “ideas to improve the State’s worker...
Dec 1, 2022
MPN Chaos: Trader Joe's Employee Denied QME Treatment
Third-Party Administrator (TPA) Sedgwick Claims Management Services, acting on behalf of ACE American Insurance Company, refused to consider authorizing care recommend...
Dec 1, 2022
Sedgwick Uses Terminated ACE American MPN to Deny Payment
The Medical Provider Network (MPN) system in California is so chaotic, even the adjusters can’t keep up.For example: Third-Party Administrator (TPA) Sedgwick Claims Ma...
Dec 1, 2022
MPN Chaos: Sedgwick Denies QME Payment - Lowe's Home Center
The Medical Provider Network (MPN) system in California is out of whack — to the point that it breeds the kind of improper payment denials that make it impossible not to ask ...
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Nov 29, 2022
CA: Sedgwick Stiffs Doctor Who Treated Injured Honda Worker
The Medical Provider Network (MPN) system in California is chaos — and chaos breeds the kind of abuse that is currently crippling workers’ comp.Case in p...