California Workers' Comp
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...
Sep 14, 2021
A Doctor's Warning: PPOs "Helped Close Our Doors"
Recently we received an email from a retired California doctor. This doctor, after 35 years treating injured workers, was unable to sell his practice — because no other provi...
Aug 25, 2021
AIG: Improper (but Logical) Med-Legal Underpayment
AIG improperly reduced a California Medical-Legal bill by 88%, providing a dramatic example of how California law incentivizes payers to incorrectly reimburse physicians who ...
Aug 19, 2021
CA Cheat Sheet: Required Reports & Supporting Documentation for Workers' Comp Bills
In California, when submitting a bill for treating an injured worker, it’s imperative to include the correct documentation to support the treatment. If the provider fails to ...