Blog: DaisyNews

Workers' Comp News, Data, and Insights

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CA Workers' Comp Q&A Highlights

Jul 13, 2021

We asked our readers to submit their most vital California workers’ comp questions for a live Q&A webinar. They did not disappoint!If you missed it, below is a brief r...

Sedgwick Denies Second Review Appeals as "Duplicates"

Jul 12, 2021

Sedgwick has a Second Review problem.On too many occasions, Sedgwick incorrectly denies providers’ Second Review appeals as “duplicate submissions” of the original bil...

IBR Hall of Shame: Sedgwick Sets New Standard of Noncompliance

Jul 6, 2021

Sedgwick failed to comply with an Independent Bill Review (IBR) ruling for almost four months. Worse, the payor’s brazenness is likely to go unpenalized by the state.T...

OMFS Update: 59 Codes Newly Billable

Jul 5, 2021

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 ...

SB 537 Reveals Murky World of Discount Contracts

Jun 30, 2021

In 2019, California passed Senate Bill 537. Among the changes to take effect on July 1st is a disclosure mandate requiring discount contracting entities to disclose to the pa...

MPNs: The Jekyll and Hyde of Workers' Comp

May 20, 2021

We’ve argued that MPNs are mostly a drag on the workers’ compensation system. But as some employers demonstrate, they don’t have to be.When employers use MPNs to maint...

Anthem: PPO Discounts Result in Payments BELOW Medicare

May 19, 2021

Q:  How much can a workers’ comp provider lose by signing a Preferred Provider Organization (PPO) agreement?A:  Much, much more than the provider probably realizes.

How to Win Med-Legal Payment Disputes

May 17, 2021

In light of the all-new Medical-Legal Fee Schedule (MLFS) for California workers’ comp, we debuted a new tool to help providers. Our MLFS “Report Cards” analyze...

CNA Repeatedly Ignores California Law

May 12, 2021

By law, claims administrators must remit payment for Medical-Legal services within 60 days of receiving the physician’s bill. As of this writing, payment to one physician fro...

Mob Rule: SCIF/Anthem Hold Patient(s) Hostage

Apr 21, 2021

On paper, Medical Provider Networks (MPNs) are a simple workers’ comp quality/cost-control measure. Employers designate an MPN, and injured workers choose from among the MPN ...

2021 CA Med-Legal Billing Codes Pocket Guide

Apr 8, 2021

California has a new Medical-Legal Fee Schedule (MLFS), effective April 1. To help medical-legal evaluators and their staff navigate these (drastic) changes, we created a dow...

Broadspire Pays Provider 47% Below CA OMFS

Apr 7, 2021

It happens every year: Reimbursement rates for workers’ compensation services in California change, and payers reimburse providers at the lesser, previous rates.It hap...

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