claims administrators
Aug 5, 2019
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
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
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
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
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 ...
Jul 2, 2019
Claims Admins Deny Second Review Appeals as Duplicate Bills
Two claims administrators, York and Sedgwick, denied hundreds of compliant second review appeals on the grounds that the appeals were “duplicates” of the Original Bills in qu...
Jun 6, 2019
Pro Tip: Submit RFAs During Liability Disputes
When the employer and injured worker are locked in an injury liability dispute, the provider is frequently caught in the crossfire. Often, treatment cannot wait for the long ...
May 23, 2019
Recent ICD-10 Updates Do Not Apply to Workers' Comp Billing
The latest in dubious denial strategies for California workers’ comp: some claims administrators are denying provider bills for being out of step with updates to the current ...
May 15, 2019
SB 537: Physicians Should REVOLT Against Inequities
DaisyBill believes every California physician should be extremely alarmed by the proposed addition of Labor Code § 138.8 in SB 537. If passed as-is, § 138.8 would require the...
May 14, 2019
Ventura Unified School District Is No Longer Using York
Ventura Unified School District is no longer using York to process medical bills. Effective 5/1/2019, Athens will be handling all claims for the Ventura Unified Schoo...
May 9, 2019
The Conco Companies Changes TPA
The Conco Companies is no longer using Athens as its Third Party Administrator (TPA). Effective 4/1/2019, Travelers will be handling all claims for The Conco Companies...
Apr 26, 2019
Crum & Forster Switches Bill Review Vendor
According to a notice received from Crum and Forster, the insurer is no longer using Corvel for processing medical bills.Effective 4/24/2019, Conduent will be handling...