claims administrators
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...
Nov 12, 2020
AIG: 11,000+ Violations and Counting
Earlier this year, AIG Claims, Inc. (AIG) made the switch to Carisk as its workers’ compensation electronic clearinghouse. However, and unfortunately, this change had no impa...
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 ...
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...
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...
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...
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...
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...
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...