California Workers' Comp
Apr 7, 2022
CA Med-Legal: How to Appeal Unpaid AME Modifier -94
Regularly, California workers’ comp claims administrators incorrectly deny Medical-Legal Fee Schedule (MLFS) modifier -94 for Agreed Medical Evaluator (AME) services. In this...
Apr 6, 2022
How to e-Bill: 835 Electronic EORs
California law mandates that when a provider bills electronically for workers’ comp services, the claims administrator must timely send the provider an electronic Explanation...
Apr 6, 2022
Claims Admin Directory: Average Days to Pay Explored
Perhaps the biggest challenge facing workers’ comp providers in California and across the US: getting paid on time. Inconsistent cash flow can back up accounts receiva...
Apr 5, 2022
Broadspire’s Confusing, Erroneous Letters to Providers
In a classic case of the left hand not knowing what the right is doing, Broadspire processed and paid providers’ e-bills, then subsequently, Broadspire sent those prov...
Apr 3, 2022
Join daisyBill at RIMS 2022 Conference
The RIMS 2022 RiskWorld Annual Conference and Exhibition is just around the corner — and daisyBill will be there!From April 10 to 13, conference attendees can swing by...
Mar 31, 2022
Farmers Insurance: Winning "IBR Chicken”
California workers’ comp technically offers an appeals process for providers to dispute incorrect reimbursements. However, this appeals process actually encourages claims adm...
Mar 30, 2022
2022 CA OMFS Update: Physician Fee Schedule
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 ...
Mar 29, 2022
ESIS Unpaid Medical-Legal Bills
Alert: ESIS has failed to pay at least 7 bills for workers’ comp Medical-Legal services, despite acknowledging receipt of the bills in question. Further, attempting to...
Mar 28, 2022
2022 CA OMFS Update: DMEPOS
California’s Division of Workers’ Compensation (DWC) updated the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) portion of the Official Medical Fee ...
Mar 23, 2022
CA How-To: Get Penalty & Interest Paid
When a bill is not paid, doctors often ask, “What about penalties and interest?” In California workers’ comp, penalty and interest payments are — in theory at least — ...
Mar 22, 2022
PPO: No Provider Recourse for Unnamed Discounts
In California workers’ comp, the appeals process for disputing improper Preferred Provider Organization (PPO) reductions has a serious flaw.Routinely, Explanations of ...
Mar 21, 2022
CA Workers' Comp: Appeals Rigged to Profit Payers
When a claims administrator incorrectly reimburses a California workers’ comp provider, the mandated process for the provider to dispute the error (or purposeful theft) is co...