Berkshire Hathaway: DWC Targeted Audit Needed ASAP
Jan 13, 2022
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 Homestate Companies (BHHC) continues to fail to compliantly process valid Second Review appeals submitted by California doctors to dispute erroneously deni...
IBR Chicken: SCIF Blinks Too Late
Jan 11, 2022
You win some, you lose some. That’s the lesson the State Compensation Insurance Fund (SCIF) must take from the latest round of California workers’ comp claims administ...
Intact Insurance Plays (Double) IBR Chicken
Jan 10, 2022
Welcome to another round of IBR Chicken! The rules are simple. To avoid reimbursing a doctor for authorized workers’ comp services, a California claims administrator m...
Berkshire Hathaway Refuses 892 Second Review Appeals
Dec 7, 2021
Berkshire Hathaway hath a way of defying California workers’ comp regulations, and refusing to pay doctors for authorized treatment provided to in...
JT2 Plays IBR Chicken (and Wins)
Dec 6, 2021
As we pointed out in 10 Ways to Fix CA Workers’ Comp (see item #5), it can seem as if payers play a twisted game of IBR Chicken with doctors, reflexively denying bills and Se...
Lien Chaos Returns: DWC Rules for Anthem (Part III)
Nov 17, 2021
California’s Division of Workers’ Compensation (DWC) has a duplicity problem. In the third chapter of our series on The Zenith and Anthem Blue Cross, we discover that ...
Zurich Refuses to Pay for Emergency Treatment
Oct 14, 2021
In a medical emergency, a doctor treats first and asks questions later. But in response to a medical emergency, Zurich refused to pay a doctor for suturing a lacerated finger...
Liberty Mutual Stiffs QME - Attorneys Required
Sep 22, 2021
Hello California Workers’ Comp Attorneys, Medical-Legal physicians in this state need your help. Payers like Liberty Mutual have found a way to skirt the Independent ...
SCIF Hacks IBR by Switching (Incorrect) Denial Reason
Sep 15, 2021
There’s a serious inequity in the appeals process by which California workers’ comp providers can dispute incorrect reimbursement for authorized treatment. State Compensation...
ESIS Fails to Pay IBR Fee on Behalf of ABM Industries
Aug 23, 2021
Ask yourself — what happens if you’re a year late paying a bill?Your credit score tanks? Your car is repossessed? Your home foreclosed on? In most walks of life...
Med-Legal: PPO Discounts Do NOT Apply to MLFS
Aug 17, 2021
Preferred Provider Organization (PPO) and other network discounts do not apply to the Medical-Legal Fee Schedule (MLFS). Period.In other words, the MLFS and OMFS are c...