e-Billing

CA EDI Compliance: 2022 e-Billing Report Card
Jan 17, 2023
CA EDI Compliance: 2022 e-Billing Report Card
For over ten years, California has had a simple legal requirement: all claims administrators must accept electronic bills from providers for the treatment of injured workers....
Tristar: 16,459 Audit Complaints Filed
Jan 5, 2023
Tristar: 16,459 Audit Complaints Filed
For all its complexity, California workers’ comp has one very simple law: if a doctor chooses to send bills electronically, the claims administrator must accept that doctor’s...
Tristar: 8,188 Audit Complaints Filed With CA DWC
Jan 5, 2023
Tristar: 8,188 Audit Complaints Filed With CA DWC
Using data generated by over 36,000 electronic bills sent by our provider clients in 2022, daisyBill demonstrates consistent non-compliance with California e-billing regulati...
Sedgwick's 57,876 Audit Complaints: A Business Practice?
Dec 14, 2022
Sedgwick's 57,876 Audit Complaints: A Business Practice?
Sedgwick received our open letter, but the Third-Party Administrator (TPA) still missed the memo. Sedgwick administers claims on behalf of insurers and self-insured em...
Sedgwick Missing e-EORs: 31,906 Audit Complaints Submitted
Dec 14, 2022
Sedgwick Missing e-EORs: 31,906 Audit Complaints Submitted
Sedgwick Claims Management Services is breaking the law. We encourage the California Division of Workers’ Compensation (DWC) to assert its role in upholding workers’ comp law...
2022 Non-Compliance Report: 6 Admins That Fail to Send e-EORs
Dec 8, 2022
2022 Non-Compliance Report: 6 Admins That Fail to Send e-EORs
California workers’ comp switched to electronic billing for very good reasons. e-Billing is much, much faster, wastes far fewer resources, and goes a very long way tow...
New York: How to Guarantee e-Bills Reach Payers
Oct 13, 2022
New York: How to Guarantee e-Bills Reach Payers
For New York State providers, electronic billing is the best way to make treating injured workers financially sustainable. But to e-bill successfully requires the provider’s ...
New York: WCB Update Affirms Electronic EOR Requirement
Oct 13, 2022
New York: WCB Update Affirms Electronic EOR Requirement
New York State’s Workers’ Compensation Board (WCB) issued an update to the mandatory Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs) required...
An Open Letter to Sedgwick Claims Management Services, Inc.
Sep 26, 2022
An Open Letter to Sedgwick Claims Management Services, Inc.
Dear Sedgwick Claims Management Services,This is a plea. In all sincerity, and all snark aside, California workers, providers, and employers need you to do bett...
Data! Top 10 Claims Admins: CA Electronic EOR Compliance
Sep 15, 2022
Data! Top 10 Claims Admins: CA Electronic EOR Compliance
Electronic Explanations of Review (e-EORs) are a non-negotiable requirement of workers’ comp electronic billing. Within 15 working days of receiving a provider’s e-bill, the ...
Berkshire Hathaway Repairs Electronic EOR Issue
Sep 15, 2022
Berkshire Hathaway Repairs Electronic EOR Issue
There’s no excuse for claims administrators not to accept and properly process electronic bills, a legal requirement in California for almost 10 years now. Ever...
AmTrust Addresses Electronic EOR Issue
Sep 15, 2022
AmTrust Addresses Electronic EOR Issue
Insurer AmTrust North America provided an excellent example of how claims administrators, working in good faith with providers, can resolve Electronic Data Interchange (EDI) ...