claims administrators
Apr 4, 2022
Claims Admin Directory - New Free Resource!
Knowledge is power, and sunshine is the best disinfectant. Nowhere are these principles more true than in workers’ compensation, where for too long a convoluted, opaqu...
Mar 13, 2022
e-Billing Data 2021: Average Days To Payment
What’s the best way to quickly receive payment for treating an injured worker? Send the bill electronically (aka: e-billing). Throughout the United States, workers’ co...
Nov 16, 2021
Zenith Boots Doctor From MPN per Anthem PPO (Part II)
Our tale of one doctor’s struggle with the Anthem Blue Cross Preferred Provider Organization (PPO) took a disturbing — if predictable — turn.Despite a doctor’s request...
Nov 15, 2021
How Zenith & Anthem Swiped a Doctor's Revenue (Part I)
This is Part I of our three-part series on one California doctor’s struggle to protect practice revenue from an unsubstantiated Anthem PPO discount.Anthem Blue Cross e...
Nov 11, 2021
The Hartford Ignores TWO California Laws
By insisting The Hartford owed no payment for authorized treatment provided outside the Medical Provider Network (MPN), The Hartford pooh-poohed a clear-cut Cal...
Aug 4, 2021
Audit Complaint: PacificComp Fails to Process e-Bills
In California workers’ comp, a provider’s failure to adhere to the billing regulations allows the payer to refuse payment for treatment of the injured worker. But all too oft...
Aug 3, 2021
Alert: Sedgwick/Availity Abrupt Split May Delay e-Bill Processing
With only hours of notice, clearinghouse Availity and third-party claims administrator (TPA) Sedgwick severed their relationship. The move may catch providers and their billi...
Jul 6, 2021
IBR Hall of Shame: Sedgwick Sets New Standard of Noncompliance
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...
May 12, 2021
CNA Repeatedly Ignores California Law
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...
May 5, 2021
Athens Must Stop Taking Unnamed PPO Discounts
As advocates for a fair and just workers’ comp system, we here at DaisyBill feel compelled to remind insurer Athens Administrators of an important fact about California worke...
May 4, 2021
CCSF Stands Up On Behalf of Providers
Many payers delegate bill review to an outside entity, trusting the bill review vendor to properly reimburse providers. But when a provider disputes a denial or adjustment, i...
Apr 29, 2021
Introducing: CA Med-Legal Fee Schedule Report Cards
At DaisyBill, we strive to help providers and their staff navigate the complexities of workers’ comp billing and payment, to ensure proper reimbursement. To that end, we’re d...