California Workers' Comp
Aug 8, 2024
daisyData: CA RFA & Utilization Review 2024 Data
In California, Utilization Review (UR) is the mandatory process by which claims administrators decide whether or not to approve treatment requests submitted by doctors treati...
Aug 7, 2024
CA DWC Defies Law, Botches WCIS
Without reliable data, no government can understand—let alone solve—the problems of any major system. Yet California’s Division of Workers’ Compensation (DWC) has openly defi...
Aug 6, 2024
Medata Harrasses CA Provider for Requesting IBR
Medata, which conducts bill review for the City of Los Angeles, just gave a master class in how claims administrators’ vendors bully providers who are simply trying to receiv...
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Aug 5, 2024
EK Health: Denying Care Helps Injured Workers
EK Health wants you to know that Utilization Review (UR) is not a soulless tool that payers use to deny injured workers the care recommended by their treating physicians....
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Jul 31, 2024
Workers' Comp Exec: WCIRB "Skews Statistics"
Widely-respected industry journal Workers’ Comp Executive recently offered a powerful, public criticism of the Workers’ Compensation Insurance Rating Bureau (WCIRB).
Jul 25, 2024
CA Workers' Comp: Broken by Design?
In response to our recent report on new, burdensome regulatory changes proposed by California’s Division of Workers’ Compensation (DWC), a California provider sent us an impa...
Jul 17, 2024
LA Metro Transit Authority: 12,879 Audit Complaints Filed
The Los Angeles County Metropolitan Transit Authority (LA Metro), a public self-insured employer, fails to fulfill one of its most basic (but essential) legal obligations to ...
Jul 16, 2024
DWC's Updated IBR Form - F Is for Fail
California’s Division of Workers’ Compensation (DWC) recently updated Form IBR-1, which providers use to request an Independent Bill Review (IBR)—but did so without publicizi...
Jul 12, 2024
CA: Orthopedist Bill Denial Rates by Claims Admin - Part 3
In the firsttwo of this series (read here and here), daisyData from orthopedic surgeon clients highlights how California’s convoluted Medical Provider Ne...
Jul 11, 2024
CA: Orthopedist Payment Data by Claims Admin - Part 2
While all providers who agree to treat injured workers are essential, in this series, daisyBill focuses on orthopedic reimbursement to expose how California’s Medical Provide...
Jul 10, 2024
CA: Orthopedists Payment Data - Part 1
Orthopedic providers are vital to workers’ compensation. daisyData reveals that since January 1, 2022, Preferred Provider Organization (PPO) entities have diverted over $18 m...
Jul 2, 2024
Sedgwick Stiffs AME for IBR Filing Fee
In California, when Independent Bill Review (IBR) overturns a Sedgwick erroneous reimbursement denial, Sedgwick owes the provider $180 (the cost of the f...