California Workers' Comp
Apr 5, 2018
WCAB Resolves Lien Deadline Issue
Lien claimants who filed required supplemental lien declarations on July 2 or 3 of 2017 wondered: would the Workers’ Compensation Appeals Board (WCAB) agree to adjudicate tho...
Apr 4, 2018
CA Physician Fee Schedule Update Adds New Billing Codes, NCCI Edits
A new order from the Administrative Director of California’s Division of Workers’ Compensation (DWC) updates the Physician and Non-physician practitioner services portion of ...
Mar 30, 2018
Location-Based Reimbursement in CA? DWC Plans Hearing on OMFS Changes
California workers’ comp providers may soon face another layer of complexity in calculating reimbursements: Geographic Practice Cost Indices (GPCI), which would raise or lowe...
Mar 29, 2018
“Secret Settlements” - Double Standard for IMR Rules
Since the introduction of Independent Medical Review (IMR), claims administrators working on behalf of employers and insurers haven’t always played fair. In seeking to uphold...
Mar 28, 2018
PR-2 Report Made Easier: Fillable and Downloadable PR-2 Report Form
Last month, we highlighted the importance of the Treating Physician’s Progress Report, which providers must use to document services rendered. This crucial bit of paperwork, ...
Mar 23, 2018
Automatic Authorization: Late Bill Submission Does Not Bar Payment
Workers’ comp providers, be warned: payors are incorrectly denying bills for automatically authorized services due to untimely submission.Untimely submission is not gr...
Mar 22, 2018
Macy’s Changes Bill Review; Sedgwick Error Causes Bill Rejections
Self-insured employer Macy’s no longer utilizes EK Health Bill Review. Effective March 3, 2018, Macy’s switched to Sedgwick Claims Management Services National Bill Review. <...
Mar 20, 2018
Discount Dangers: The CA Provider’s Bill of Rights (Right V)
Discount Dangers is a DaisyBill series on the ways some discount contracts unscrupulously reduce providers’ reimbursements. With this series we shine a light on the worst pra...
Mar 16, 2018
TPA Change: JCPenney Switches Third-Party Administrator
JCPenney no longer utilizes third-party claims administrator Sedgwick Claims Management Services. The retail department store chain transferred all claims to AIG Claims, Inc....
Mar 16, 2018
FYI: American Airlines Changes Bill Review
Self-insured employer American Airlines no longer utilizes Genex Services Bill Review. Effective February 1, 2018, American switched to Sedgwick Claims Management Services Na...
Mar 15, 2018
Outpatient/ASC Fee Schedule: DWC Issues (Then Corrects) Reimbursements
The California Division of Workers’ Compensation (DWC) ordered new adjustments to the Official Medical Fee Schedule (OMFS), effective March 15, 2018. The orders update fees f...
Mar 13, 2018
How Workers’ Comp Payments By Credit Card Hurt CA Providers
Accepting credit cards from patients for co-pays and deductibles is one thing, but it makes zero financial sense for California providers to accept credit card payments from ...