California Workers' Comp
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...
Sep 15, 2022
AmTrust Addresses Electronic EOR Issue
Insurer AmTrust North America provided an excellent example of how claims administrators, working in good faith with providers, can resolve Electronic Data Interchange (EDI) ...
Sep 7, 2022
CA SCIF Baits & Switches MD Out of Payment
Once again, California’s State Compensation Insurance Fund (SCIF) may profit by exploiting a flaw in California’s Independent Bill Review (IBR) system.SCIF initially d...
Sep 7, 2022
ESIS Pays Med-Legal Bills Following Audit Complaints
California physicians can always rely on ESIS to pay its bills for Medical-Legal services — as long as they're willing to report ESIS to the Division of Workers’ Compensation...
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...
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 ...
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 ...
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...