California Workers' Comp
Dec 7, 2021
Berkshire Hathaway Refuses 892 Second Review Appeals
Berkshire Hathaway hath a way of defying California workers’ comp regulations, and refusing to pay doctors for authorized treatment provided to in...
Dec 6, 2021
JT2 Plays IBR Chicken (and Wins)
As we often point out, it can seem as if payers play a twisted game of IBR Chicken with doctors, reflexively denying bills and Second Review appeals only to change their mind...
Nov 30, 2021
10 Ways to Fix CA Workers' Comp
Today, the California Division of Workers’ Compensation (DWC) will host a virtual public meeting “to hear ideas to improve the efficiency and quality of care provided to inju...
Nov 17, 2021
Lien Chaos Returns: DWC Rules for Anthem (Part III)
California’s Division of Workers’ Compensation (DWC) has a duplicity problem. In the third chapter of our series on The Zenith and Anthem Blue Cross, we discover that ...
Nov 11, 2021
The Hartford Ignores TWO California Laws
By insisting The Hartford owed no payment for authorized treatment provided outside the Medical Provider Network (MPN), The Hartford pooh-poohed a clear-cut Cal...
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Nov 10, 2021
PPO vs Network: Who's Taking Your Money?
We’ve told the story many times: a doctor signs a discount contract, hoping to bring in more patients. Almost immediately, revenue for treating injured workers is down across...
Nov 10, 2021
WCIRB: "Frictional" Workers' Comp Costs Soar in CA
Workers’ comp is wildly inefficient in California, according to the Workers’ Compensation Insurance Rating Bureau (WCIRB). The WCIRB used hard data to clearly d...
Nov 4, 2021
AIG & Coventry (and California) Squeeze QME
California Medical-Legal physician evaluators, be advised: some payers still attempt to improperly apply Preferred Provider Organization (PPO) discounts to Medical-Legal bill...
Nov 3, 2021
E/M: Not the PTP? How to Bill for Required Reports
For Evaluation and Management (E/M) in California workers’ comp, Primary Treating Physicians (PTP) must submit with the bill a progress report using either the ...
Nov 3, 2021
Record Review Sends Med-Legal Costs Soaring
Like a bored multi-billionaire, Medical-Legal expenses for California workers’ comp are needlessly approaching the stratosphere.Our data point to the pri...
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Nov 2, 2021
Data: Discount Entities Plunder CA OMFS
Workers’ comp payers throughout California ignore the state fee schedule and fail to reimburse providers the mandated reimbursements rates as allowed by the sta...
Oct 14, 2021
Zurich Refuses to Pay for Emergency Treatment
In a medical emergency, a doctor treats first and asks questions later. But in response to a medical emergency, Zurich refused to pay a doctor for suturing a lacerated finger...