California Workers' Comp
Sep 5, 2019
Claims Admins EXPLOIT Lack of Regulations in Timely Filing Law
In 2016, California State Bill 1160 was signed into law, instituting new timely filing requirements for workers’ comp medical treatment bills. Since 2017, Labor Code Section ...
Aug 26, 2019
Technical Difficulties Trouble San Diego Bill Review Switch
The City of San Diego, a self-insured, self-administered California employer, is in the process of switching bill review services from Genex to Medata. The transition, though...
Aug 23, 2019
South San Francisco, Marin County Change TPAs
Two municipal employers in California switched third-party administrators (TPAs). Both the City of South San Francisco and the County of Marin transferred claims from TriStar...
Aug 16, 2019
SCIF, CorVel IBR Withdrawal Requests Create ENORMOUS Hassles for Providers
The billing lesson for today: providers should never agree to withdraw a request for Independent Bill Review (IBR), no matter how sweetly the payor begs. Trust us; we’ve lear...
Aug 15, 2019
Select Staffing: Changes TPA and Claim Numbers
Attention California providers: Select Staffing no longer uses CorVel as its Third-Party Administrator (TPA).Effective July 1, 2019, Broadspire administers all claims ...
Aug 5, 2019
Blatant Disregard for IBR Law by Sedgwick, Gallagher, Athens, Helmsman
A disturbing pattern is emerging from the results of Independent Bill Review (IBR) decisions in the state of California. As usual, the problem encumbers workers’ comp provide...
Aug 1, 2019
Berkshire Hathaway Fails to Process Second Review Appeals
Berkshire Hathaway Homestate Companies (BHHC) is failing to process electronic second review appeals, leaving providers in an unacceptable payment limbo. The insurer incorrec...
Jul 29, 2019
Costco, Home Depot, & Other Employers Should Be Mad as HEL*
Recently a provider shared a letter, apparently meant to intimidate, that it received from a Liberty Mutual Network Specialist, Peter Spalding. The letter threatened to kick ...
Jul 17, 2019
Mitchell Unresolved EOR Mess
A persistent glitch in Mitchell’s bill review service is causing revenue management chaos for providers. For second review appeals, providers receive electronic explanations ...
Jul 11, 2019
TPA Alert: LA County Switches Claims Administrators
Effective July 1, 2019, the County of Los Angeles is no longer utilizing third-party claims administrator (TPA) TriStar Risk Management. Claims are transferred to eith...
Jul 10, 2019
CA OMFS: DMEPOS Fee Schedule Update Effective 7/1/2019
In Newsline No.: 2019-53, the California Division of Workers’ Compensation (DWC) announced updates to the Official Medical Fee Schedule for Durable Medical Equipment, Prosthe...
Jul 9, 2019
CA OMFS Update: Pathology/Clinical Lab Fee Schedule for 7/1/2019
On July 8, 2019, California’s Division of Workers’ Compensation (DWC) ordered an update to the Pathology and Clinical Laboratory section of the Official Medical Fee Schedule ...