claims administrators
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...
Oct 14, 2019
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...
Oct 9, 2019
Audit Complaint Form Updated in California
Recently the California Division of Workers Compensation (DWC) updated the Audit Complaint form used by providers to report claims administrator non-compliance. The up...
Oct 3, 2019
Liberty Mutual and a Cautionary Tale of Payment Woes
Today we’re sharing a maddening and all-too-common story of payment woes, this time featuring Liberty Mutual as the miscreant that just won’t pay a bill correctly -- despite ...
Sep 20, 2019
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
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
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 ...
Sep 4, 2019
Liberty Mutual, Gallagher Bassett, Chubb Scoff at CA IBR Rules
It’s still happening: claims administrators including Liberty Mutual, Gallagher Bassett, and Chubb are ignoring the rules regarding Independent Bill Review (IBR), brazenly re...
Aug 23, 2019
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
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
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 8, 2019
NonCompliant CNA, Crum & Forster, County of San Diego - Electronic EORs Not Optional
As California continues its transition to fully paperless workers’ comp billing and payment, some claims administrators have apparently decided to follow their own regulation...