California Workers' Comp
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...
Jul 1, 2024
CA OMFS Update: Physician Services (Q3 2024)
California’s Division of Workers’ Compensation (DWC) issued an update to the Physician and Non-Physician Practitioner portion of the Official Medical Fee Schedule (OMFS) for ...
Jun 28, 2024
Anthem's THM Network Closes, Stiffs Providers
Workers’ comp providers—in particular ancillary providers like physical therapists (PTs)—take note: if you have treated injured workers through Anthem’s Transparent Health Ma...
Jun 26, 2024
CCSF Sends Corrected Payments to Providers
No one knows better than daisyBill how much payment abuse California workers’ comp providers endure.This is why our hearts blossom when claims administrators and their...
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Jun 25, 2024
Zurich - An Example of California's MPN Shell Game
Where opacity and obfuscation reign, injustice thrives. There may be no better example of this than California’s Medical Provider Network (MPN) system. T...
Jun 20, 2024
99¢ Stores: Athens Halts Processing Bills
In April of this year, 99 Cents Only Stores LLC declared bankruptcy, leaving the self-insured employer with no way to pay its Third-Party Administrator (TPA), Athens Administ...
Jun 19, 2024
CA MPNs Harm Employers, Injured Workers & Providers
California’s Medical Provider Network (MPN) system is an unmitigated failure, causing genuine harm to injured workers, health care providers, and employers. The Divisi...
Jun 18, 2024
AmTrust MPN Magic Denies Payment
Welcome to California workers’ comp, where claims administrators can use even the most demonstrably, objectively, provably untrue assertions to deny payment to a provider—wit...
Jun 17, 2024
CA DWC: Claims Administrators' IBR Wingman
In California, claims administrators can expect little or no repercussions for failing to comply with workers’ comp payment laws and regulations. Meanwhile, the Divisi...