IBR
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 ...
Feb 29, 2024
CA Med-Legal Billing: 3 Tips to Win IBR Disputes
Statistically, California Medical-Legal evaluators are highly likely to prevail at Independent Bill Review (IBR) — but that doesn’t mean physician evaluators can’t benefit fr...
Feb 28, 2024
CA Med-Legal MDs: Don't Accept Denials or Adjustments - IBR Works!
California Medical-Legal physician evaluators, Independent Bill Review (IBR) is your friend.According to data from the Division of Workers’ Compensation (DWC), 96% of ...