California Workers' Comp
May 22, 2023
RFA: The Easy Way to Manage UR Decisions
So many injuries. So many Requests for Authorization (RFAs). So many Utilization Review (UR) decisions to keep track of — and only so much time in a day.Rest easy, pro...
May 18, 2023
CA Makes Treating Injured Workers Unsustainable
Why are doctors unwilling to treat injured workers?In California, injured workers often struggle to find doctors willing to provide treatment. The main reason for this...
May 17, 2023
SCIF vs Gallagher Bassett: E&M Reimbursement
When evaluated on key metrics such as denial of payments and reimbursement amounts, some claims administrators embody the major issues plaguing the California workers' compen...
May 16, 2023
Gallagher Bassett Plays IBR Chicken With QME
Gallagher Bassett seemingly tried its hand at the game of IBR Chicken, forcing a Qualified Medical Evaluator (QME) to waste time, money, and resources on a needless dispute —...
May 15, 2023
SCIF Makes Mockery of IBR and the DWC
Yet again, we face another appalling round of "IBR Chicken,” the game in which a claims administrator refuses to shell out a dime to a California provider for services render...
May 10, 2023
MSQ Network - Payment Chaos
Today, Assembly Bill 1278 is being considered by the Appropriations Committee. This bill will grant barely-regulated network entities almost complete control over Medical Pro...
May 9, 2023
RFA: How Technology Can Document UR Decisions
For providers, workers’ comp’s biggest challenges are obtaining authorization for treatment, and getting paid for providing the authorized treatment. Both chall...
May 8, 2023
Audit Complaints: The Hartford Has No Excuse
Making workers’ comp more efficient and effective in restoring injured workers to health should be a cooperative effort among stakeholders, not a combative one. But when an o...
May 4, 2023
CA Committee Passes Disastrous AB 1278
California physicians, it’s time to take a stand.Last week, the Assembly's Insurance Committee endorsed Assembly Bill 1278, and forwarded it to the Appro...
May 3, 2023
Hartford and P2P Fail CA e-Billing
California workers’ comp has lots of complicated laws, but one law is simple: claims administrators must accept electronic bills from providers. Since claims administr...
May 2, 2023
RFA: What's the Fax Number? daisyAuth Knows
They don’t make it easy to treat injured workers in California.To receive payment, a provider must obtain permission from the employer or insurer for all treatment ren...
Apr 27, 2023
Sedgwick Racks Up 79,318 DWC Audit Complaints
Third-Party Administrator (TPA) Sedgwick Claims Management Services, Inc. continues to ignore California workers’ comp billing regulations with impunity.Currently, Sed...