claims administrators

ESIS + Conduent + StrataCare  = Provider Torment
Mar 2, 2021
ESIS + Conduent + StrataCare = Provider Torment
Preferred Provider Organizations (PPOs) profit from reducing the reimbursements providers receive for treating injured workers. Yet, we would argue that providers (and injure...
ESIS & ABM Industries - IBR Hall of Shame
Jan 28, 2021
ESIS & ABM Industries - IBR Hall of Shame
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
Is ESIS Gaming California's Work Comp System?
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...
Data PROVES Electronic Billing for Workers' Comp Works
Nov 10, 2020
Data PROVES Electronic Billing for Workers' Comp Works
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 ...
DaisyBill Automates Zurich Second Review Appeals
Oct 21, 2020
DaisyBill Automates Zurich Second Review Appeals
DaisyBill recently broke the story (after receiving multiple reports from the DaisyBill community and beyond) that Zurich has improperly denied California providers’ bills fo...
When Zurich Speaks, Garbled Noncompliance Comes Out
Oct 20, 2020
When Zurich Speaks, Garbled Noncompliance Comes Out
We are writing about Zurich again, as the claims administrator’s conduct continues to be a symptom of the deep unfairness that permeates California’s workers’ comp system. Th...
Zurich: Triples Down on Foul Play
Oct 15, 2020
Zurich: Triples Down on Foul Play
Clearly Zurich fears no recourse as it continues to systematically ignore rules while stripping California providers of proper reimbursement. In this latest development, Zuri...
Zurich: CORRECT Appeal Instructions for Zurich Denials
Oct 5, 2020
Zurich: CORRECT Appeal Instructions for Zurich Denials
Today, we explain the COMPLIANT protocol for California providers to dispute the noncompliant denials that Zurich recently issued, and that were based on its completely nonco...
Zurich Further Jeopardizes Providers' Payment With Incorrect Appeal Instructions
Oct 2, 2020
Zurich Further Jeopardizes Providers' Payment With Incorrect Appeal Instructions
Even when there is potential payer fraud, California requires the provider -- not the payer -- to shoulder the burden of correcting claims administrator “mistakes.” For the t...
Employers Should Demand That Zurich Pay Providers
Sep 30, 2020
Employers Should Demand That Zurich Pay Providers
Yesterday we published the first in a series of urgent articles alerting California’s workers’ comp community that Zurich is refusing to pay providers who treat injured worke...
URGENT: Zurich Refusing to Pay Providers for Treating Injured CA Workers
Sep 29, 2020
URGENT: Zurich Refusing to Pay Providers for Treating Injured CA Workers
This is an URGENT article written to alert California workers’ comp providers that Zurich is incorrectly denying workers’ comp bills by citing the untimely filing of the bill...
Hanover –> What the H*llover is Going On?
Nov 21, 2019
Hanover –> What the H*llover is Going On?
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...