e-EOR

ESIS e-EOR Compliance Nosedives; Vendors Step Up to Help

Third-Party Administrator (TPA) ESIS recently switched bill review vendors, which unfortunately delayed the delivery of thousands of electronic Explanations of Review (e-EORs...

Sedgwick Authorizes FedEx Care. Then Stiffs the Provider.

Third-Party Administrator (TPA) Sedgwick Claims Management Services authorized treatment for an injured FedEx employee — and then refused to pay for it. Worse, Sedgwick won't...

CCMSI e-EOR Violations Create Chaos for Providers

In California and other states, payers must respond to providers' electronic bills (e-bills) with electronic Explanations of Review (e-EORs), which automatically post payment...

accūrō Solutions: Proactive Bill Review Improves Compliance for Payers

It’s not all bad news in the world of workers’ comp billing. While daisyNews regularly holds payers and their vendors accountable for their failures, some companies de...

NYSIF e-EOB Non-Compliance Rises in 2025

The New York State Insurance Fund (NYSIF) is making it harder for providers to treat the state’s injured workers by repeatedly failing to comply with payment requirements for...

Adminsure Billing Nightmare: Public Pays the Price for Friction (Part 2)

In Part 1 of our exposé on Adminsure, we detailed the painful odyssey providers must endure just to confirm payment for the treatment of injured workers.Below, we spot...

Adminsure Makes Billing a Nightmare for Providers (Part 1)

Adminsure is a prime example of why providers hesitate to treat injured workers.In multiple cases, Adminsure compliantly sent an electronic Explan...

Sedgwick Hits 298,034 Violations (and Counting)

Sedgwick Claims Management Services, Inc. continues to violate a critical California payment requirement with apparent impunity. The Third-Party Administrator (...

NY Billing Alert: Payers Deny CPT 99080 for 64% of e-Bills

As of August 1, 2025, New York mandates that providers submit all bills for injured workers’ medical treatment electronically (e-billing). To offset the cost of e-bill...

NY Data: Payers That Fail to Respond to Providers' e-Bills

Since August 2025, New York has required workers’ comp medical providers to send their workers' comp bills electronically (e-bills). Since October 2021, the New York W...

Taxpayers Beware: Anaheim Misreports Payment Data

Citizens of Anaheim, CA, may want to examine the city’s books closely, given the suspicious accounting of taxpayer dollars designated for the care...

Careworks Hurts Employers, Providers, and Payers

Employers buy workers’ comp insurance expecting their premium dollars to pay for their injured employees’ treatment. Providers expect timely, accurate payment for treating in...