California Workers' Comp
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...
%20rounded.gif)
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...
Oct 6, 2021
CA Med-Legal Reporting Deadline Extension Official
California’s Division of Workers’ Compensation (DWC) has officially extended emergency regulations which add 15 days to the usual time frame for Medical-Legal reporting.<...
Sep 30, 2021
Coming Soon: CA Med-Legal Billing Data
There’s only one way to understand, navigate, and improve workers’ compensation: by the numbers.Since the introduction of the new Medical-Legal Fee Schedule (MLFS) in ...
Sep 29, 2021
PPO Data Update: The Toll on CA Doctors Who Treat Injured Workers
DaisyBill’s California OMFS Reimbursement Reduction page tracks in minute detail the data around Preferred Provider Organization (PPO) and other discount contracts. Now, we’v...
Sep 28, 2021
TPA Changes: City of Alameda, Torrance Unified Schools
Two California public employers switched third-party administrators (TPA) recently, affecting bills for all dates of service. The City of Alameda and the Torrance Unified Sch...
Sep 27, 2021
Pasadena Is (Still) Violating CA Workers' Comp Law
As costs skyrocket, physicians flee the system, and injured workers find it harder and harder to find a doctor willing to treat them, California workers’ comp has yet to reck...
Sep 21, 2021
Dollar Tree/Sedgwick Won’t Pay for Authorized Treatment
Authorization is, by definition, a promise.It’s the promise that, once a doctor obtains authorization from an employer to treat an injured worker, the employer will pa...
Sep 16, 2021
Med-Legal Reports: Always Include Page Count Verification!
California’s new Medical-Legal Fee Schedule (MLFS), effective from April 2021, brought with it new rules for reporting, billing, and payment. Among those rules: when submitti...
Sep 15, 2021
SCIF Hacks IBR by Switching (Incorrect) Denial Reason
There’s a serious inequity in the appeals process by which California workers’ comp providers can dispute incorrect reimbursement for authorized treatment. State Compensation...