EOR

Sedgwick Missing e-EORs: 25,970 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...

Data: e-EOR Compliance Rates

To facilitate electronic billing for workers’ comp, California requires all claims administrators to respond to provider e-bills with electronic EORs (e-EORs). Within 15 work...

AmTrust: Serious Violation of CA e-Billing Law

AmTrust North America refuses to comply with the most basic workers’ comp electronic billing mandates. In that refusal, AmTrust completely undermines the purpose of workers’ ...

How to e-Bill: 835 Electronic EORs

California law mandates that when a provider bills electronically for workers’ comp services, the claims administrator must timely send the provider an electronic Explanation...

How to Identify PPO Reductions (Part I)

Daily, we hear from workers’ comp providers requesting help with identifying whether Pilfering Provider Organizations (aka: PPOs) are hijacking the funds intended to pay for ...

ESIS Refuses to Answer Phone or Pay Med-Legal Doctor

ESIS, a third-party administrator (TPA) for Ace American Insurance, is failing miserably in its legal duty to timely reimburse a California physician evaluator for Medical-Le...