IBR
May 16, 2023
Gallagher Bassett Plays IBR Chicken With QME
Gallagher Bassett seemingly tried its hand at the game of IBR Chicken, forcing a Qualified Medical Evaluator (QME) to waste time, money, and resources on a needless dispute —...
May 15, 2023
SCIF Makes Mockery of IBR and the DWC
Yet again, we face another appalling round of "IBR Chicken,” the game in which a claims administrator refuses to shell out a dime to a California provider for services render...
Apr 21, 2023
Sedgwick Loses IBR (But Still Wins "IBR Chicken")
You can’t say we didn’t try.Earlier this month, we offered Third-Party Administrator (TPA) Sedgwick Claims Management Services, Inc. 100% free use of our daisyWizard f...
Mar 15, 2023
CPT 99358 & 99359: How to Appeal Payment Denials
In workers’ comp billing, some procedure codes are trickier than others.Two of the best examples are CPT codes 99358 and 99359, used by providers to report prolonged n...
Jan 30, 2023
Med-Legal IBR Data: A Bad Look for Sedgwick & CA
California appears to turn a willfully blind eye to what seems like an abuse of the Independent Bill Review (IBR) system for Medical-Legal disputes.Data ...
Dec 8, 2022
Med-Legal Data: IBR Is the QME/AME's Friend
California workers’ comp presents serious challenges to physicians — and Medical-Legal physicians are no exception. Despite a recently simplified Medical-Legal Fee Sch...
Dec 8, 2022
CA QME Calls Out Cannon Cochran "Abuse and Insults"
A California Qualified Medical Evaluator (QME) has had quite enough nonsensical reimbursement games from Cannon Cochran Management Services, Inc. (CCMSI).The Third-Par...
Dec 5, 2022
CA Providers Unite! Suggestions for the DWC
On December 6, 2022, California’s Division of Workers’ Compensation (DWC) invites stakeholders to a public meeting to share “ideas to improve the State’s worker...
Sep 7, 2022
CA SCIF Baits & Switches MD Out of Payment
Once again, California’s State Compensation Insurance Fund (SCIF) may profit by exploiting a flaw in California’s Independent Bill Review (IBR) system.SCIF initially d...
Sep 7, 2022
IBR: Sedgwick Ordered to Pay QME $20k+ for False Med-Legal Denial
Sedgwick Claims Management Services just set a dubious new record. Maximus, the entity which conducts Independent Bill Review (IBR) on behalf of California’s Division of Work...
Jul 27, 2022
SCIF: Med-Legal IBR Chicken Champion
Welcome to another round of IBR Chicken, where California claims administrators (falsely) deny payment for the treatment of injured workers for implausible reasons — and keep...
Jul 12, 2022
SCIF Stiffs Doc by Paying AFTER Request for IBR
In a classically underhanded move, California’s State Compensation Insurance Fund (SCIF) twice denied payment for the authorized treatment of an injured worker, but then sudd...