AmTrust - IBR Hall of Shame
Sep 15, 2020
Below, we document the flouting of workers’ compensation law by AmTrust North America (AmTrust), and its continued refusal to reimburse a provider despite being ordered to do...
Sally Beauty Holdings: Changes TPA and Claim Numbers
Nov 26, 2019
Sally Beauty Holdings no longer uses CorVel as its third-party administrator (TPA).Effective November 15, 2019, Broadspire administers all claims for Sally Beauty Hold...
Hanover –> What the H*llover is Going On?
Nov 21, 2019
We have yet another tale of a payer flagrantly ignoring its duty to compliantly process provider bills for treatment of injured workers. This account of payer friction highli...
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...