Fee Schedule
Jun 25, 2019
CA Physician MUE Reimbursement Change as of 7/1/2019
In Newsline No.: 2019-46, the California Division of Workers’ Comp (DWC) announced changes to the Official Medical Fee Schedule for Physician Services / Non-Physician Practit...
May 29, 2019
Let's Make This Clear: Workers' Comp Is Not Medicare
A recent post by Joe Paduda perpetuates the common but incorrect practice of analogizing workers’ comp to Medicare. In his discussion, Paduda notes that Medicare pays much le...
May 17, 2019
Alert: More Unreasonable Physician Reporting Demands
When it comes to billing complications, some California payers are demanding documentation for time-based procedure codes; a demand that is unsubstantiated by California work...
Apr 5, 2019
8 Minute How-To: Multiple Procedure Payment Reduction (MPPR)
This short, free, and super-useful video demystifies Multiple Procedure Payment Reductions (MPPRs) for Physician and Non-Physician Practitioner Services in California.
Mar 29, 2019
9 Minute How-To: Geographic Practice Cost Indices (GPCIs)
Confused by the 2019 introduction of Geographic Practice Cost Indices (GPCIs) to Physician Services reimbursements?In just nine minutes you will know the reason Fresno...
Mar 4, 2019
Assistant at Surgery: All You Need to Know
Last week, we opened Pandora’s box on co-surgeons and team surgery. Notably left in the box was a discussion on assistant(s) at surgery. Typically this arises when physicians...
Mar 1, 2019
📬 Payer Responses: Guile, Waiting, and Crickets 🏏
Today we report on the responses from Sedgwick, Liberty Mutual, York, and State Compensation Insurance Fund (SCIF), following our posts detailing their systematic underpaymen...
Feb 26, 2019
Co-Surgery vs. Team Surgery: All You Need to Know
Surgery in workers’ compensation cases opens a Pandora’s box: reserves go up, nurse case managers get involved, and surgeons need to justify every detail of their billing to ...
Feb 15, 2019
Liberty Mutual Trifecta of Incorrect Payments
In this, our fourth story on the fiasco of 2019 workers’ comp payments, we turn to the errors of Liberty Mutual. By now, from reading about Sedgwick, York, and Sedgwick (agai...
Feb 8, 2019
The Payment Chaos Continues: Sedgwick Denies Appeal for Correct 2019 Reimbursements
Sedgwick’s payment mistakes multiply. First, Sedgwick incorrectly paid California providers by applying an old workers’ comp fee schedule. Now Sedgwick compounds its error by...
Feb 6, 2019
2019 Splinting & Casting Reimbursement Update
When navigating the seas of change, it’s refreshing to find an island of relative stability. Like California’s state-specific codes, the splinting and casting codes group (co...
Feb 4, 2019
California-Specific Codes Updated for 2019
With the flurry of new year fee schedule changes, California updated the Physician Fee Schedule reimbursement for its state-specific codes. These codes are explained in 8 CCR...