IBR
Nov 21, 2024
CA: Alert - IBR Filing Fee to Increase in 2025
Pursuing correct payment for treating injured workers is about to get even more expensive for California providers.When a claims administrator incorrectly denies or re...
Oct 3, 2024
Travelers Defies IBR, Shorts CA QME
How many ways can an insurer violate workers’ comp payment laws, regulations, and rules on a single bill?Travelers may have set the benchmark by refusing to correctly ...
Aug 13, 2024
Apricus Applies Massive, Invalid PPO Discount for Sedgwick
Specialty network vendor Apricus, acting on behalf of Third-Party Administrator (TPA) Sedgwick, recently applied an invalid Preferred Provider Organization (PPO) discount to ...
Aug 6, 2024
Medata Harrasses CA Provider for Requesting IBR
Medata, which conducts bill review for the City of Los Angeles, just gave a master class in how claims administrators’ vendors bully providers who are simply trying to receiv...
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Jul 30, 2024
CA DWC & Maximus Rig IBR to Hand Sedgwick the Win
The California Division of Workers’ Compensation (DWC), nominally responsible for enforcing workers’ comp laws, regulations, and rules for all parties involved, continues to ...
Jul 16, 2024
DWC's Updated IBR Form - F Is for Fail
California’s Division of Workers’ Compensation (DWC) recently updated Form IBR-1, which providers use to request an Independent Bill Review (IBR)—but did so without publicizi...
Jul 2, 2024
Sedgwick Stiffs AME for IBR Filing Fee
In California, when Independent Bill Review (IBR) overturns a Sedgwick erroneous reimbursement denial, Sedgwick owes the provider $180 (the cost of the f...
Jun 18, 2024
AmTrust MPN Magic Denies Payment
Welcome to California workers’ comp, where claims administrators can use even the most demonstrably, objectively, provably untrue assertions to deny payment to a provider—wit...
Jun 17, 2024
CA DWC: Claims Administrators' IBR Wingman
In California, claims administrators can expect little or no repercussions for failing to comply with workers’ comp payment laws and regulations. Meanwhile, the Divisi...
May 3, 2024
Sedgwick Fails to Pay IBR Filing Fee for Zillionth Time
Once more for the cheap seats: when Independent Bill Review (IBR) determines that a claims administrator erroneously denied or adjusted the reimbursement owed to a provider, ...
Apr 25, 2024
Sedgwick: IBR Filing Fee Hall of Shame (Again!)
Another day, another IBR fee run-around. California law is clear: when Independent Bill Review (IBR) overturns a claims administrator’s incorrect adjudication of a provider’s...
Apr 10, 2024
AmeriTrust: IBR Hall of Shame
Can claims administrators defy California law, make up their own proprietary payment rules, and refuse to reimburse providers who treat injured workers correctly? The answer ...