Broadspire Knows No Law But Its Own
Apr 2, 2021
Broadspire continues to break the rules, seemingly confident that California regulators will not hold the claims administrator to account. For months, we reported on B...
Zurich Denies Liability After Accepting Liability
Mar 30, 2021
Zurich recently denied liability for an injured workers’ treatment, claiming the 2003 injury was not work-related — despite the fact that Zurich already authorized the treatm...
Travelers, SCIF Incorrectly Apply New E/M Rules Before Effective Dates
Mar 25, 2021
Every year, we see claims administrators incorrectly deny reimbursement because they fail to keep up with the latest changes to the Official Medical Fee Schedule (OMFS). But ...
IBR Hall of Shame: Employers
Mar 24, 2021
Employers Holdings set a shameful new standard of indifference with regard to promptly and correctly reimbursing providers. The insurer incorrectly denied payment, disregarde...
Gallagher Bassett, Foster Farms Lay A Rotten Egg in CA
Mar 12, 2021
Update: As of April 1, 2021 Gallagher Bassett can locate and process claims for Foster Farms employees. Workers’ compensation claims for injured employees of Foster Fa...
ESIS + Conduent + StrataCare = Provider Torment
Mar 2, 2021
Preferred Provider Organizations (PPOs) profit from reducing the reimbursements providers receive for treating injured workers. Yet, we would argue that providers (and injure...
Warning: Do Not Accept Credit Cards as Payment
Feb 23, 2021
In the past we have written a number of posts (including one about Broadspire) warning providers to not accept credit card payments issued by payers such as claims administra...
Sedgwick & Mitchell Setting Up a Legal Protection Racket?
Feb 22, 2021
Sedgwick, in cahoots with Mitchell, seems to be setting up some kind of protection racket where, in exchange for providers accepting lower reimbursement, Sedgwick/Mitchell wi...
ESIS & ABM Industries - IBR Hall of Shame
Jan 28, 2021
We continue to look at the misbehavior of ESIS, which yesterday entered the IBR Hall of Shame for its deplorable treatment of a provider who prevailed in two Independent Bill...
Is ESIS Gaming California's Work Comp System?
Jan 27, 2021
In this latest installment of the IBR Hall of Shame, we chronicle the never-ending payment torture inflicted on a provider who “wins” an Independent Bill Review (IBR). This i...
AIG: 11,000+ Violations and Counting
Nov 12, 2020
Earlier this year, AIG Claims, Inc. (AIG) made the switch to Carisk as its workers’ compensation electronic clearinghouse. However, and unfortunately, this change had no impa...
Data PROVES Electronic Billing for Workers' Comp Works
Nov 10, 2020
COVID-19 and our recent elections highlight the flaws, delays, and increasing creakiness of the US postal system. In 2020, as mail fails, electronic bill transmission offers ...