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Blog: DaisyBill News

News, data, & insights about workers' comp billing

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Let's Make This Clear: Workers' Comp Is Not Medicare

May 29, 2019

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...

Alert: More Unreasonable Physician Reporting Demands

May 17, 2019

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...

8 Minute How-To: Multiple Procedure Payment Reduction (MPPR)

Apr 5, 2019

This short, free, and super-useful video demystifies Multiple Procedure Payment Reductions (MPPRs) for Physician and Non-Physician Practitioner Services in California.

Assistant at Surgery: All You Need to Know

Mar 4, 2019

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...

📬 Payer Responses: Guile, Waiting, and Crickets 🏏

Mar 1, 2019

Today we report on the responses from Sedgwick, Liberty Mutual, York, and State Compensation Insurance Fund (SCIF), following our posts detailing their systematic underpaymen...

Co-Surgery vs. Team Surgery: All You Need to Know

Feb 26, 2019

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 ...

The Payment Chaos Continues: Sedgwick Denies Appeal for Correct 2019 Reimbursements

Feb 8, 2019

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...

2019 Splinting & Casting Reimbursement Update

Feb 6, 2019

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...

California-Specific Codes Updated for 2019

Feb 4, 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...

Sedgwick Still Reimbursing at 2018 Rates for California

Feb 1, 2019

Since the beginning of 2019, Sedgwick CMS has incorrectly used the 2018 Physician Fee Schedule to reimburse providers. Our data indicates that Sedgwick is consistently and in...

CA OMFS Inpatient Hospital Fee Schedule Update

Nov 29, 2018

California’s Division of Workers’ Compensation (DWC) posted an adjustment to the Inpatient Hospital section of the Official Medical Fee Schedule (OMFS), effective for dischar...

CA OMFS Update: Physician Services and DMEPOS

Jun 29, 2018

California’s Division of Workers’ Compensation (DWC) posted update orders to two sections of the Official Medical Fee Schedule (OMFS), both effective July 1, 2018. The...

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