Discount Contracts

Triton Gouges Providers - Pays 78% of Medicare Rates

Triton Healthcare Partners and Apricus (formerly Preferred Care Solutions) are collaborating with other Preferred Provider Organization (PPO) entities to hijack payments from...

Lien Chaos Returns: DWC Rules for Anthem (Part III)

California’s Division of Workers’ Compensation (DWC) has a duplicity problem. In the third chapter of our series on The Zenith and Anthem Blue Cross, we discover that ...

Zenith Boots Doctor From MPN per Anthem PPO (Part II)

Our tale of one doctor’s struggle with the Anthem Blue Cross Preferred Provider Organization (PPO) took a disturbing — if predictable — turn.Despite a doctor’s request...

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

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

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

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 Reports: Always Include Page Count Verification!

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

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

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

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

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...