Evaluation & Management Services
May 18, 2023
CA Makes Treating Injured Workers Unsustainable
Why are doctors unwilling to treat injured workers?In California, injured workers often struggle to find doctors willing to provide treatment. The main reason for this...
May 17, 2023
SCIF vs Gallagher Bassett: E&M Reimbursement
When evaluated on key metrics such as denial of payments and reimbursement amounts, some claims administrators embody the major issues plaguing the California workers' compen...
Feb 22, 2023
CPT 99358 & 99359: Payable in 2023
California workers’ comp billing is complicated — but that’s what daisyBill is here for.Effective February 15, 2023, an update to the Official Medical Fee Schedule (OM...
Feb 9, 2023
E/M Data: CPT 99214 Reimbursement 2022
Far too often, California providers are not receiving Official Medical Fee Schedule (OMFS) rates for Evaluation and Management (E/M) for injured workers — as evidenced by our...
Feb 8, 2023
Data: SCIF Pays Medicare Rates for E/M Services
Like The Zenith, California’s State Compensation Insurance Fund (SCIF) consistently pays Medicare rates to doctors for treating injured workers.According to data from ...
Feb 7, 2023
Data: Zenith Pays Medicare Rates for E/M Services
According to data from over 10,000 e-bills submitted for 2022 dates of service via daisyBill, insurer The Zenith paid 76% of the reimbursement rates established by California...
Oct 4, 2022
WCIRB Report Obscures CA Workers' Comp's Real Challenges
A report from the Workers’ Compensation Insurance Rating Bureau (WCIRB) of California asserts that in 2021, “overall medical payments per claim increased significantly.” Howe...
Jun 8, 2022
CA OMFS: E/M Reimbursement vs Medicare Reimbursement
California workers’ comp allows discount networks to bleed the doctors who treat injured workers. Unfortunately for these workers and their employers, many of these financial...
Jan 7, 2022
2022 E/M Reimbursement Rates for CA Workers' Comp - Facility
California’s Division of Workers’ Compensation recently posted new reimbursement rates for Evaluation and Management (E/M) services. Below we list the new facility reimbursem...
Jan 6, 2022
2022 E/M Reimbursement for CA Workers' Comp - Non-Facility
California’s Division of Workers’ Compensation recently posted new reimbursement rates for Evaluation and Management (E/M) services. Below we list the new non-facility reimbu...
Nov 3, 2021
E/M: Not the PTP? How to Bill for Required Reports
For Evaluation and Management (E/M) in California workers’ comp, Primary Treating Physicians (PTP) must submit with the bill a progress report using either the ...
Mar 25, 2021
Travelers, SCIF Incorrectly Apply New E/M Rules Before Effective Dates
Every year, we see claims administrators incorrectly deny reimbursement because they fail to keep up with the latest changes to the Official Medical Fee Schedule (OMFS). But ...