Electronic Billing

Berkshire Hathaway: DWC Targeted Audit Needed ASAP
Jan 13, 2022
Berkshire Hathaway: DWC Targeted Audit Needed ASAP
As Berkshire Hathaway HomeState Companies (BHHC) persists in its failure to compliantly process thousands of valid Second Review appeals, the California Divisio...
Berkshire Hathaway Ignores THOUSANDS of Second Review Appeals (& CA Law)
Jan 12, 2022
Berkshire Hathaway Ignores THOUSANDS of Second Review Appeals (& CA Law)
Berkshire Hathaway Homestate Companies (BHHC) continues to fail to compliantly process valid Second Review appeals submitted by California doctors to dispute erroneously deni...
Berkshire Hathaway Refuses 892 Second Review Appeals
Dec 7, 2021
Berkshire Hathaway Refuses 892 Second Review Appeals
Berkshire Hathaway hath a way of defying California workers’ comp regulations, and refusing to pay doctors for authorized treatment provided to in...
Pasadena Is (Still) Violating CA Workers' Comp Law
Sep 27, 2021
Pasadena Is (Still) Violating CA Workers' Comp Law
As costs skyrocket, physicians flee the system, and injured workers find it harder and harder to find a doctor willing to treat them, California workers’ comp has yet to reck...
Sedgwick: Sketchy EOR Math for LA Unified School District
Aug 11, 2021
Sedgwick: Sketchy EOR Math for LA Unified School District
Sedgwick recently returned an Explanation of Review (EOR) that failed to fulfill a crucial requirement: showing how Sedgwick actually calculated the reimbursement amount paid...
City of Pasadena: CompIQ Saves the Day
Aug 10, 2021
City of Pasadena: CompIQ Saves the Day
Following a switch to a new third-party claims administrator (TPA), the City of Pasadena violated California law by suddenly failing to accept electronic bills for the treatm...
Disneyland Churns Out Incorrect e-Bill Rejections
Aug 5, 2021
Disneyland Churns Out Incorrect e-Bill Rejections
Providers billing Disneyland Resorts, be warned: your electronic bills might be erroneously rejected.Recently, we reported on Disneyland Resorts’ switching its bill re...
Audit Complaint: PacificComp Fails to Process e-Bills
Aug 4, 2021
Audit Complaint: PacificComp Fails to Process e-Bills
In California workers’ comp, a provider’s failure to adhere to the billing regulations allows the payer to refuse payment for treatment of the injured worker. But all too oft...
Alert: Sedgwick/Availity Abrupt Split May Delay e-Bill Processing
Aug 3, 2021
Alert: Sedgwick/Availity Abrupt Split May Delay e-Bill Processing
With only hours of notice, clearinghouse Availity and third-party claims administrator (TPA) Sedgwick severed their relationship. The move may catch providers and their billi...
Warning: Do Not Accept Credit Cards as Payment
Feb 23, 2021
Warning: Do Not Accept Credit Cards as Payment
In the past we have written a number of posts (including one about Broadspire) warning providers to not accept credit card payments issued by payers such as claims administra...
Payer Refuses to Send Electronic EORs Despite Clear Law
Feb 11, 2021
Payer Refuses to Send Electronic EORs Despite Clear Law
The California law regarding electronic explanations of review (EORs) is crystal clear and completely unambiguous -- at least to the vast majority of the workers’ comp commun...
Fresno USD Fails to Comply with Electronic Billing Regulations
Feb 10, 2021
Fresno USD Fails to Comply with Electronic Billing Regulations
For providers treating injured workers, electronic billing is by far the best billing option. For claims administrators in California, it’s not optional at all; accepting ele...