California Workers' Comp
Nov 2, 2022
Employers Insurance: False MPN Payment Denial
California allows insurers and self-insured employers to establish Medical Provider Networks (MPNs) to direct injured workers’ care. While Employers Preferred Insurance Compa...
Nov 2, 2022
Gallagher Bassett: False MPN Denial
In yet another instance of a claims administrator improperly denying payment because the provider was (allegedly) not a member of the applicable Medical Provider Network (MPN...
Nov 2, 2022
AmTrust: False MPN Payment Denial
AmTrust North America, a Third-Party Administrator (TPA), offered a perfect example of what makes the Medical Provider Network (MPN) system so challenging for California work...
Oct 13, 2022
CA MPN List Updates Q4 2022
The California Division of Workers’ Comp (DWC) updated its list of Medical Provider Networks (MPNs). The DWC update:Added 2 new MPNsApproved 3 previously suspen...
Oct 13, 2022
How "Fast-Track" UR Can Backfire for CA Providers
California’s “Fast-Track” Utilization Review (UR) initially sounded like good news for doctors who provide the first treatment following a work-related injury. ...
Oct 6, 2022
Practice Recovers $1 Million Annually via Second Review Appeals
It’s official: daisyBill providers have recovered over $100 million in revenue by electronically submitting Second Review appeals to dispute incorrect reimbursements f...
Oct 6, 2022
CA OMFS Update: Physician Fee Schedule - Q4 2022
California’s Division of Workers’ Compensation (DWC) issued an update to the Physician and Non-Physician Practitioner portion of the Official Medical Fee Schedule (OMFS) for ...
Oct 6, 2022
DWC Proposes More Time to Schedule QME Appointment
California’s Division of Workers’ Compensation (DWC) will hold a public hearing on significant proposed changes to the regulations governing Medical-Legal evaluations.
Oct 4, 2022
WCIRB Report Obscures CA Workers' Comp's Real Challenges
A report from the Workers’ Compensation Insurance Rating Bureau (WCIRB) of California asserts that in 2021, “overall medical payments per claim increased significantly.” Howe...
Sep 26, 2022
An Open Letter to Sedgwick Claims Management Services, Inc.
Dear Sedgwick Claims Management Services,This is a plea. In all sincerity, and all snark aside, California workers, providers, and employers need you to do bett...
Sep 15, 2022
ALERT! AIG Moving All Claims to Gallagher Bassett
Important update for providers: Third-Party Administrator (TPA) AIG Claims, Inc. will no longer administer workers’ comp claims. All claims currently administered by A...
Sep 15, 2022
Berkshire Hathaway Repairs Electronic EOR Issue
There’s no excuse for claims administrators not to accept and properly process electronic bills, a legal requirement in California for almost 10 years now. Ever...