California Workers' Comp
Feb 21, 2018
Reminder: E/M Reimbursements Higher in 2018
*Update: The 2021 OMFS updates drastically changed how E/M codes are billed.*Some of the most commonly used billing codes by our providers, Evaluation an...
Feb 16, 2018
Authorization/Utilization Review: Why Peer-to-Peer Calls Are a Bad Idea
There’s been lots to say about authorization and utilization review (UR) this year, especially given the major changes to the process. However, one UR rule that remains the s...
Feb 15, 2018
How to Bill for Physician-Dispensed Pharmaceuticals
Payments for physician-dispensed drugs are some of the most misunderstood — and incorrectly denied — in workers’ compensation billing. Too often, the employer or insurer’s cl...
Feb 13, 2018
Providers: Don't Accept 2017 OMFS Rates for 2018 Dates of Service
Lately, we’ve noticed a problem. Some claims administrators are reimbursing providers incorrectly. Instead of paying the higher 2018 Official Medical Fee Schedule (OMFS), cla...
Feb 9, 2018
What’s New for Workers’ Comp in 2018: CA Senate Bill 1160
In 2016 California passed Senate Bill 1160, which heralded significant workers’ compensation reform. SB 1160 outlined major changes to authorization, utilization review, lien...
Feb 8, 2018
Treatments That Do NOT Qualify for Automatic Authorization in Workers’ Comp
Automatic authorization for California workers’ comp is in effect, but not all treatments qualify. In fact, the Division of Workers’ Compensation (DWC) has specificall...
Feb 7, 2018
“Automatic” Authorization, but Denied Bill? How to Appeal the Denial
The new “automatic” authorization process for workers’ comp is in effect, as of January 1. We’ve discussed this new system extensively on our blog and in our recent webinar, ...
Feb 2, 2018
2018 Workers’ Comp Reimbursement Cheat Sheet
*Update: The 2021 OMFS updates drastically changed how E/M codes are billed.*Here it is: your complete, downloadable go-to resource for California worker...
Feb 1, 2018
Fast-Track UR for Workers’ Comp: New Rules for Entities Conducting UR
We spent the last few weeks bringing readers up to speed on the new “automatic” authorization and “fast-track” utilization review (UR) process for workers’ comp. While we’ve ...
Jan 30, 2018
Work Comp: How to Bill for P&S Reports (Do Not Use ML102!)
Some providers mistakenly believe that Permanent and Stationary (P&S) reports are billable with medical-legal billing code ML102 for Basic Comprehensive Medical-Legal Evaluat...
Jan 26, 2018
Bill Review: What It Is, and Why It’s Hurting Workers’ Compensation
Bill review is very profitable. Sadly, that profit comes at the expense of other stakeholders in workers’ comp. Bill review is a huge part of the workers’ comp billing...
Jan 24, 2018
Medical-Legal Cheat Sheet: Reimbursements
Update: for dates of service on or after April 1, 2021, refer to our 2021 Med-Legal Cheat Sheet for California workers’ comp.Billing for medical-legal services is one ...