claims administrators
Mar 7, 2019
SCIF IBR Disputes Are Further Proof of Provider Reimbursement Chaos
We are again chronicling the reimbursement pandemonium inflicted on providers by the current California Second Review appeal and Independent Bill Review (IBR) processes.<...
Mar 5, 2019
2018 Average Days to Payment for Interpreter & Copy Services
Last year, more than 107,000 interpreter and copy service bills were processed by DaisyBill. The top 20 claims administrators took an average of 10Â business days to process t...
Mar 1, 2019
📬 Payer Responses: Guile, Waiting, and Crickets 🏏
Today we report on the responses from Sedgwick, Liberty Mutual, York, and State Compensation Insurance Fund (SCIF), following our posts detailing their systematic underpaymen...
Feb 27, 2019
2018 Average Med-Legal Days to Pay
In 2018, for California medical-legal bills submitted using DaisyBill software, the average processing time is 13Â business days to receive payment for the top 20 claims admin...
Feb 22, 2019
2018 Average Days to Payment for Medical Treatment Bills
In 2018, for California medical treatment bills submitted using DaisyBill software, the average processing time is 11 days for the top 20 claims administrators by volume. We’...
Feb 20, 2019
SCIF (CA) Incorrectly Paying 2018 Fee Schedule for 2019 DOS
It’s SCIF’s turn. The California State Compensation Insurance Fund (SCIF) is also incorrectly reimbursing providers using the 2018 Physician Fee Schedule instead of the corre...
Feb 8, 2019
The Payment Chaos Continues: Sedgwick Denies Appeal for Correct 2019 Reimbursements
Sedgwick’s payment mistakes multiply. First, Sedgwick incorrectly paid California providers by applying an old workers’ comp fee schedule. Now Sedgwick compounds its error by...
Feb 5, 2019
State Farm Workers’ Comp Claims Moved to Sedgwick CMS
Time to start counting your poultry -- State Farm’s workers’ compensation henhouse is now guarded by the third-party administrator (TPA) Sedgwick, effective October 21, 2018....
Feb 1, 2019
Sedgwick Still Reimbursing at 2018 Rates for California
Since the beginning of 2019, Sedgwick CMS has incorrectly used the 2018 Physician Fee Schedule to reimburse providers. Our data indicates that Sedgwick is consistently and in...
Nov 8, 2018
CA Claims Admin Delays Payment, Skirts IBR Rules
When the Independent Bill Review (IBR) process overturns a claims administrator’s incorrect denial or adjustment, the claims administrator is legally bound to timely pay what...
Sep 25, 2018
IBR Accountability: Claims Admins Fail to Pay Providers
California regulations mandate that when Independent Bill Review (IBR) overturns a claims administrator’s incorrect bill denial or adjustment and finds in favor of the provid...
Aug 24, 2018
Broadspire Denies Unprocessed Workers’ Comp Bills
Broadspire, a global third-party claims administrator (TPA), incorrectly denied several bills for the treatment of an injured worker. While incorrect denials are nothing new ...