Discount Contracts

How Zenith & Anthem Swiped a Doctor's Revenue (Part I)
Nov 15, 2021
How Zenith & Anthem Swiped a Doctor's Revenue (Part I)
This is Part I of our three-part series on one California doctor’s struggle to protect practice revenue from an unsubstantiated Anthem PPO discount.Anthem Blue Cross e...
Data: Discount Entities Plunder CA OMFS
Nov 2, 2021
Data: Discount Entities Plunder CA OMFS
Workers’ comp payers throughout California ignore the state fee schedule and fail to reimburse providers the mandated reimbursements rates as allowed by the sta...
PPO Data Update: The Toll on CA Doctors Who Treat Injured Workers
Sep 29, 2021
PPO Data Update: The Toll on CA Doctors Who Treat Injured Workers
DaisyBill’s California OMFS Reimbursement Reduction page tracks in minute detail the data around Preferred Provider Organization (PPO) and other discount contracts. Now, we’v...
Data: Drastic PPO Discounts Revealed
Sep 13, 2021
Data: Drastic PPO Discounts Revealed
It’s time to reveal what’s really harming injured workers in California. Starting today, DaisyBill will publicize the reduced reimbursement rates foisted on our provid...
Med-Legal: PPO Discounts Do NOT Apply to MLFS
Aug 17, 2021
Med-Legal: PPO Discounts Do NOT Apply to MLFS
Preferred Provider Organization (PPO) and other network discounts do not apply to the Medical-Legal Fee Schedule (MLFS). Period.In other words, the MLFS and OMFS are c...
SB 537 Reveals Murky World of Discount Contracts
Jun 30, 2021
SB 537 Reveals Murky World of Discount Contracts
In 2019, California passed Senate Bill 537. Among the changes to take effect on July 1st is a disclosure mandate requiring discount contracting entities to disclose to the cl...
Athens Must Stop Taking Unnamed PPO Discounts
May 5, 2021
Athens Must Stop Taking Unnamed PPO Discounts
As advocates for a fair and just workers’ comp system, we here at DaisyBill feel compelled to remind insurer Athens Administrators of an important fact about California worke...
CCSF Stands Up On Behalf of Providers
May 4, 2021
CCSF Stands Up On Behalf of Providers
Many payers delegate bill review to an outside entity, trusting the bill review vendor to properly reimburse providers. But when a provider disputes a denial or adjustment, i...
Prime Health: Unsigned Contract Tale Continues
May 3, 2021
Prime Health: Unsigned Contract Tale Continues
Almost immediately after DaisyBill called out Prime Health Services (PHS) for questionable PPO practices, it was clear we struck a nerve. PHS attorneys sent DaisyBill a ‘plea...
Mob Rule: SCIF/Anthem Hold Patient(s) Hostage
Apr 21, 2021
Mob Rule: SCIF/Anthem Hold Patient(s) Hostage
On paper, Medical Provider Networks (MPNs) are a simple workers’ comp quality/cost-control measure. Employers designate an MPN, and injured workers choose from among the MPN ...
Provider Warning: Prime Health Services (Part II)
Apr 20, 2021
Provider Warning: Prime Health Services (Part II)
Prime Health Services (PHS) provided an unbelievable example of just how far PHS will go to secure unearned PPO discounts for their “clients”, including producing a missing s...
How To Stop A Network From Taking Your Revenue
Mar 22, 2021
How To Stop A Network From Taking Your Revenue
Recently, a DaisyBill provider contacted us to discuss a disturbing network contract, one that expands its net well beyond what this provider initially believed...