claims administrators

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...
Gallagher Bassett: Audit Complaint Filed With DWC
Oct 7, 2020
Gallagher Bassett: Audit Complaint Filed With DWC
In a previous article, we demonstrated how Gallagher Bassett ignores the California-mandated workers’ comp Official Medical Fee Schedule (OMFS). Gallagher Bassett also ignore...
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...
AmTrust -  IBR Hall of Shame
Sep 15, 2020
AmTrust - IBR Hall of Shame
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: Changes TPA and Claim Numbers
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
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...