California Workers' Comp
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Jun 5, 2024
Gallagher Bassett Denies Bill, Spews Nonsense, Ignores Appeal
Welcome to California workers’ comp, where a claims administrator’s legal obligation to timely pay providers’ bills is more a matter of theory than practice.Safe from ...
Jun 4, 2024
CA Payment Denial Rates - Top 20 Claims Administrators
Bill data collected from daisyBill clients during the first four months of 2024 reveal claims administrators’ disturbing propensity to refuse payment for injured workers’ tre...
May 31, 2024
CA Appeals: Sutter Health Pays for Frankenreport
In our previous article, daisyNews detailed how Sutter Health authorized a California provider to create a strange combination of a Permanent and Stationary (P&S) report and ...
May 30, 2024
daisyData: CA e-EOR Most / Least Compliant Claims Admins
California mandates that all (repeat: all) workers’ comp claims administrators accept electronic bills from providers and respond to those e-bills with electronic Explanation...
May 29, 2024
CA Provider Warning: P&S vs Med-Legal Reports
This is an essential report warning for California providers. A Permanent and Stationary (PR-4) report and a Medical-Legal evaluation report are not interchangeable. Before i...
May 28, 2024
Santa Monica & Lien on Me Improperly Reimburse MDs
In California workers’ comp, claims administrators often suffer from a troubling payment syndrome we call “Fee Schedule Lag.” The symptoms of Fee Schedul...
May 21, 2024
CA: Del Taco Fails to Pay for Injured Employees
Need (yet another) illustration of what happens when a state establishes a consequence-free environment for workers’ comp claims administrators? There is currently no ...
May 13, 2024
Sedgwick Stiffs Doctors With Outdated Fee Schedule Rates
The California Division of Workers’ Compensation (DWC) increased reimbursements for physician services for dates of service on or after April 1, 2024. Yet Third-Party Adminis...
May 7, 2024
CorVel Corrects Reimbursement Errors
California workers’ comp fee schedules aren’t easy to keep up with. Subject to constant revision, the complex formulas for calculating correct reimbursement are more t...
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May 6, 2024
Marriott (Finally) Sending e-EORs
Fans of workers’ comp billing and payment compliance, rejoice! After literally years of hounding from daisyBill, self-insured employer Marriott is finally adhering to ...
May 3, 2024
Sedgwick Fails to Pay IBR Filing Fee for Zillionth Time
Once more for the cheap seats: when Independent Bill Review (IBR) determines that a claims administrator erroneously denied or adjusted the reimbursement owed to a provider, ...
May 2, 2024
Orange County/Sedgwick Inflict MPN Mayhem
How much of California workers’ comp dysfunction directly results from the effectively ungoverned Medical Provider Network (MPN) system? California does not furnish an...