claims administrators
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...
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...
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...
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...
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...