claims administrators
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...
Apr 27, 2021
California MPNs: Camouflage for Discounts and Denials
Medical Provider Networks (MPNs) are under fire — as they should be.Far too often, Calforina claims administrators (aka ‘payers’) use MPNs — and providers’ unfamiliari...
Apr 2, 2021
Broadspire Knows No Law But Its Own
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...
Mar 30, 2021
Zurich Denies Liability After Accepting Liability
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...
Mar 25, 2021
Travelers, SCIF Incorrectly Apply New E/M Rules Before Effective Dates
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 ...
Mar 24, 2021
IBR Hall of Shame: Employers
Employers Holdings set a shameful new standard of indifference with regard to promptly and correctly reimbursing providers. The insurer incorrectly denied payment, disregarde...
Mar 12, 2021
Gallagher Bassett, Foster Farms Lay A Rotten Egg in CA
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...
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...
Feb 23, 2021
Warning: Do Not Accept Credit Cards as Payment
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...
Feb 22, 2021
Sedgwick & Mitchell Setting Up a Legal Protection Racket?
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...
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...
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...