California Workers' Comp
Dec 14, 2017
In Workers' Comp, Authorization Is Final
Let’s be very clear: in the workers’ comp dialect of Legalese, “authorization” means guaranteed payment for approved services. Period.While one can imagine scenarios i...
Dec 12, 2017
Provider Alert: California Prescription Drug Formulary Effective January 2018
Last week, California’s Office of Administrative Law approved the Division of Workers’ Compensation (DWC)’s proposed evidence-based drug formulary. Through the formulary, the...
Dec 8, 2017
Medical-Legal Billing Lacks Necessary Rules
When it comes to medical-legal billing, the workers’ comp field is missing something. For medical-legal bills, no rules govern the billing form used or the method used...
Dec 4, 2017
Alert: Patriot National, Inc. and Guarantee Insurance Co. Threatened Collapse
Patriot National Inc., an end-to-end insurance services business that includes third-party administrator Patriot Risk Services, recently defaulted on its debt and laid off ab...
Dec 1, 2017
2018 Authorization/Utilization Review: Major Changes Effective 1/1/2018
Senate Bill 1160 makes significant changes to the authorization and utilization review (UR) process starting in 2018. New “fast-track” UR takes effect on January 1. Fa...
Nov 30, 2017
Billing Tip: Cumulative Trauma Date of Injury
Compliant billing is crucial for providers to obtain proper reimbursement for treating injured workers. One important, but occasionally tricky, aspect of compliant billing is...
Nov 29, 2017
Outpatient/ASC Coding: J1 Combinations and C-APC
No one said work comp billing was easy. In fact, we say just the opposite, all the time. That’s why we created DaisyBill, and why we do our best to offer as many helpful tips...
Nov 21, 2017
Why Work Comp Providers Need Specialized RCM
Workers’ compensation is different.It’s a labyrinth of legal and procedural twists, turns, and obstacles that don’t plague providers in other areas of medicine. When i...
Nov 17, 2017
Overpaid? Don't Rush to Return Payment to Claims Admin
Mistakes regarding the complex new Status Indicators have left some claims administrators scrambling to recover erroneous payments — even to the point of threatening provider...
Nov 16, 2017
5 Strategies to Prevent Denied Work Comp Bills
California does not make it easy for work comp providers to get paid. The time and effort necessary to obtain proper reimbursement is an unfortunate reality of a system weigh...
Nov 15, 2017
Coding Clinic: How to Bill for Evaluation & Management Services
As the Centers for Medicare and Medicaid Services (CMS) like to say, “If it is not documented, it has not been done.” Of course, documenting can be just as painstaking as the...
Nov 10, 2017
How It Works: Independent Medical Review (IMR)
When the claims administrator representing the insurance company, employer, or TPA denies a valid, compliant Request for Authorization (RFA), what’s a work comp provider to d...