claims administrators
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
CNA, Crum & Forster, County of San Diego: e-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...
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 ...