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claims administrators
Oct 14, 2019
3 min read
0
The Zenith Unsucessfully Attempts to Undermine IBR Request
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...
Sep 20, 2019
2 min read
0
Huntington Hospital & City of Beverly Hills Change TPAs
Attention providers: two California employers switched third-party administrators (TPAs).Huntington Hospital transferred claims from Sedgwick to AthensCity of B...
Sep 19, 2019
2 min read
0
York (aka Sedgwick) Fails Math: EORs Literally Don't Add Up
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...
Sep 5, 2019
4 min read
0
Claims Admins EXPLOIT Lack of Regulations in Timely Filing Law
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 ...
Aug 23, 2019
1 min read
0
South San Francisco, Marin County Change TPAs
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...
Aug 16, 2019
4 min read
0
SCIF, CorVel IBR Withdrawal Requests Create ENORMOUS Hassles for Providers
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...
Aug 15, 2019
2 min read
0
Select Staffing: Changes TPA and Claim Numbers
Attention California providers: Select Staffing no longer uses CorVel as its Third-Party Administrator (TPA).Effective July 1, 2019, Broadspire administers all claims ...
Aug 5, 2019
4 min read
0
Blatant Disregard for IBR Law by Sedgwick, Gallagher, Athens, Helmsman
A disturbing pattern is emerging from the results of Independent Bill Review (IBR) decisions in the state of California. As usual, the problem encumbers workers’ comp provide...
Jul 29, 2019
2 min read
0
Costco, Home Depot, & Other Employers Should Be Mad as HEL*
Recently a provider shared a letter, apparently meant to intimidate, that it received from a Liberty Mutual Network Specialist, Peter Spalding. The letter threatened to kick ...
Jul 17, 2019
3 min read
0
Mitchell Unresolved EOR Mess
A persistent glitch in Mitchell’s bill review service is causing revenue management chaos for providers. For second review appeals, providers receive electronic explanations ...
Jul 11, 2019
2 min read
0
TPA Alert: LA County Switches Claims Administrators
Effective July 1, 2019, the County of Los Angeles is no longer utilizing third-party claims administrator (TPA) TriStar Risk Management. Claims are transferred to eith...
Jul 8, 2019
2 min read
0
Magna Carta - Bills Not Processed
Providers, be aware that Magna Carta Companies (formerly PSM) ended its relationship with its bill review service, CorVel. More importantly, Magna Carta is not responding to ...
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