The Zenith Unsucessfully Attempts to Undermine IBR Request
Oct 14, 2019
Claims administrators continue to innovate new techniques that make it harder for providers to receive proper reimbursement. In this installment, we tell a tale of the length...
Audit Complaint Form Updated in California
Oct 9, 2019
Recently the California Division of Workers Compensation (DWC) updated the Audit Complaint form used by providers to report claims administrator non-compliance. The up...
Liberty Mutual and a Cautionary Tale of Payment Woes
Oct 3, 2019
Today we’re sharing a maddening and all-too-common story of payment woes, this time featuring Liberty Mutual as the miscreant that just won’t pay a bill correctly -- despite ...
Huntington Hospital & City of Beverly Hills Change TPAs
Sep 20, 2019
Attention providers: two California employers switched third-party administrators (TPAs).Huntington Hospital transferred claims from Sedgwick to AthensCity of B...
York (aka Sedgwick) Fails Math: EORs Literally Don't Add Up
Sep 19, 2019
York Risk Services, which was acquired this month by Sedgwick, has significant math troubles. York recently returned Explanations of Review (EORs) which obfuscated the effect...
Claims Admins EXPLOIT Lack of Regulations in Timely Filing Law
Sep 5, 2019
In 2016, California State Bill 1160 was signed into law, instituting new timely filing requirements for workers’ comp medical treatment bills. Since 2017, Labor Code Section ...
Liberty Mutual, Gallagher Bassett, Chubb Scoff at CA IBR Rules
Sep 4, 2019
It’s still happening: claims administrators including Liberty Mutual, Gallagher Bassett, and Chubb are ignoring the rules regarding Independent Bill Review (IBR), brazenly re...
South San Francisco, Marin County Change TPAs
Aug 23, 2019
Two municipal employers in California switched third-party administrators (TPAs). Both the City of South San Francisco and the County of Marin transferred claims from TriStar...
SCIF, CorVel IBR Withdrawal Requests Create ENORMOUS Hassles for Providers
Aug 16, 2019
The billing lesson for today: providers should never agree to withdraw a request for Independent Bill Review (IBR), no matter how sweetly the payor begs. Trust us; we’ve lear...
Select Staffing: Changes TPA and Claim Numbers
Aug 15, 2019
Attention California providers: Select Staffing no longer uses CorVel as its Third-Party Administrator (TPA).Effective July 1, 2019, Broadspire administers all claims ...
NonCompliant CNA, Crum & Forster, County of San Diego - Electronic EORs Not Optional
Aug 8, 2019
As California continues its transition to fully paperless workers’ comp billing and payment, some claims administrators have apparently decided to follow their own regulation...
Blatant Disregard for IBR Law by Sedgwick, Gallagher, Athens, Helmsman
Aug 5, 2019
A disturbing pattern is emerging from the results of Independent Bill Review (IBR) decisions in the state of California. As usual, the problem encumbers workers’ comp provide...