CareWorks
Jul 1, 2025
Sedgwick: Careworks' Bulk Payments - Employers Take Note (Part 2)
Yesterday daisyNews reported on a California provider inexplicably receiving three large checks from Preferred Provider Organization (PPO) Careworks, purporting to bulk-pay 1...
Jun 30, 2025
Sedgwick: Non-Compliant Bulk Payments From Careworks (Part 1)
In California, claims administrators—and apparently, Preferred Provider Organizations (PPOs)—are effectively free to create their own payment rules. A provider submitt...
Jun 20, 2025
City of Riverside Pays MD $31 by Triple-Stacking PPOs
This week’s Diabolical Discounter is the City of Riverside. This self-insured public employer slashed a doctor’s reimbursement for a municipal worker’s Evaluation and Managem...
Oct 17, 2019
York EORs Create Revenue Management Headaches
York Insurance has repeatedly reported incorrect payment amounts in recent Final Explanations of Review (EORs), which are issued in response to second review appeals. These F...