Discount Contracts
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...
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...
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...
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...
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...
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 ...
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...
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...
May 2, 2019
SB 537: Say NO to Medicare Reimbursements
A proposed California bill, though seemingly benign, may establish Medicare rates as a standard for workers’ comp reimbursements, which would be a mistake. The bill, w...
May 11, 2018
Discount Dangers: The Provider’s Bill of Rights (Rights VI and VII)
Discount Dangers is a DaisyBill series on the ways discount contracts unscrupulously lower work comp providers’ reimbursements. With this series, we shine a light on the wors...
Mar 20, 2018
Discount Dangers: The CA Provider’s Bill of Rights (Right V)
Discount Dangers is a DaisyBill series on the ways some discount contracts unscrupulously reduce providers’ reimbursements. With this series we shine a light on the worst pra...
Mar 6, 2018
Discount Dangers: The Provider’s Bill of Rights (Rights III and IV)
Discount Dangers is a daisyBill series on the ways discount contracts incorrectly reduce providers’ reimbursements. With this series, we shine a light on the worst discount p...