Discount Contracts
Jul 24, 2025
Diabolical Discounts: Rampant Anthem PPO Carnage
Preferred Provider Organization (PPO) Anthem Blue Cross is enabling egregious abuse of California providers at scale. Since June, dozens of claims administrators have ...
Jul 18, 2025
Diabolical Discounts: Berkshire Hathaway's Reimbursement Roulette (Part 1)
A sad fact about California workers’ comp: once a doctor joins a Preferred Provider Organization (PPO), there’s no predicting how devastating the impact on practice revenue w...
Jun 20, 2025
City of Riverside Pays MD $31 by Triple-Stacking PPOs
This week’s Diabolical Discounter is the City of Riverside. This self-insured public employer slashed a doctor’s reimbursement for a municipal worker’s Evaluation and Managem...
Jun 13, 2025
Diabolical Discounts: CA Employers Are Getting Ripped Off
In California, doctors who treat injured workers are seeing their revenue collapse due to exploitative discount reimbursement schemes. California Senate Bill 863, whic...
May 28, 2025
Insurance Execs Make Bank While Comp Crumbles
Business Insurance recently named the five highest-paid executives in the country for 2024. These executives’ compensation packages are, as expected, massive—an...
May 13, 2025
Long Beach Pays CA Doctors Less Than Interpreters (and Plumbers)
Last week’s Diabolical Discounts revealed that the City of Long Beach paid a doctor just over $32 to treat an injured municipal employee. The article provoked outrage–and com...
May 9, 2025
Diabolical Discounts: Long Beach Pays Doctor $32 to Treat Injured Employee
Across the nation, providers struggle to treat injured workers without financially damaging their practices. The problem is especially ugly in California, where extrem...
May 1, 2025
Please Advise: An Open Letter to the CA DWC (cc: CA Attorneys)
We have a question for California’s Division of Workers’ Compensation (CA attorney comments are always welcomed, too): What should a medical practice do in the followi...
Apr 10, 2025
Sedgwick’s Shell Game: From Coventry to CareWorks, the Chicanery Continues
Sedgwick Claims Management Services, Inc., a Third-Party Administrator (TPA), appears to be throwing any available spaghetti at the wall to continue funneling e...
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Apr 9, 2025
Enlyte’s MPI: A Smokescreen to Protect Private Equity Profits
Last week, Enlyte—the parent company of Coventry, Mitchell, and Genex, all backed by private equity firm Stone Point Capital—released its latest report on its “Medical Price ...
Jan 11, 2024
Provider Alert! New 2024 TRPN DirectPay Scheme
There may be no company in the workers’ comp space with a worse reputation than Three Rivers Provider Network DirectPay (TRPN). But this discount contracting entity st...
Nov 14, 2023
Provider Alert: MTI Discount "Contract"
A daisyBill provider client received a disturbing document purporting to authorize treatment for an injured employee of City and County of San Francisco (CCSF). MTI Am...