California Workers' Comp
Nov 8, 2022
CA Med-Legal: Q&A for Confused Physicians
Recently, a physician evaluator reached out to us with questions regarding Medical-Legal services for California workers’ comp. Rather than share the answers with this physic...
Nov 8, 2022
Midwest Insurance Fails to Pay QME
If there’s any doubt regarding why California workers’ comp is facing a shortage of Qualified Medical Evaluators (QMEs), look no further than Midwest Insurance. Midwest has b...
Nov 8, 2022
ALERT: Municipal Pooling Authority Bounces QME Check (Twice)
The Municipal Pooling Authority (MPA) recently bounced a check to a California Qualified Medical Evaluator (QME) — not once, but twice. According to MPA representative...
Nov 2, 2022
MPNs: How to Detect Dubious Payment Denials
In California workers’ comp, one of the biggest — but least talked about — challenges for providers is navigating the Medical Provider Network (MPN) system. MPNs were ...
Nov 2, 2022
Sedgwick Stiffs QME With False MPN Denial (Again)
It’s been said that insanity is best defined by doing the same thing repeatedly, but expecting different results. If that’s the case, Sedgwick Claims Management Services has ...
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 ...