Blog: DaisyBill News

News, data, & insights about workers' comp billing

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Claims Admins Deny Second Review Appeals as Duplicate Bills

Jul 2, 2019

Two claims administrators, York and Sedgwick, denied hundreds of compliant second review appeals on the grounds that the appeals were “duplicates” of the Original Bills in qu...

CA Payors Put the Squeeze on Providers (Again)

Jun 13, 2019

In California, box 1a of the CMS 1500 billing form is for the injured worker’s Social Security Number (SSN). When the claims administrator insists the provider populate box 1...

SCIF (CA) Incorrectly Paying 2018 Fee Schedule for 2019 DOS

Feb 20, 2019

It’s SCIF’s turn. The California State Compensation Insurance Fund (SCIF) is also incorrectly reimbursing providers using the 2018 Physician Fee Schedule instead of the corre...

IBR Appeal Analysis for CPTs 99358 & 99359

Feb 19, 2019

Reimbursements for CPTs 99358 & 99359 are tricky because payers frequently deny reimbursement for services that are not face-to-face with patients. Previously, we presented t...

Liberty Mutual Trifecta of Incorrect Payments

Feb 15, 2019

In this, our fourth story on the fiasco of 2019 workers’ comp payments, we turn to the errors of Liberty Mutual. By now, from reading about Sedgwick, York, and Sedgwick (agai...

Maximus Confirms Using Second Review Appeals to Correct Billing Errors

Feb 12, 2019

Correcting a coding error is as simple as submitting a Second Review appeal explaining the error. Last year, we discussed the convoluted process to correct billing err...

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...

Data: Excessive Workers’ Comp Claim Denials Backfire

Aug 31, 2018

An industry study tells an interesting story about workers’ compensation claims. A significant upward trend in denials ultimately cost employers and their claims administrato...
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Confusion and Running in Circles: AIG / MedRisk Incorrect Denials

Jan 24, 2017

Recently DaisyBIll providers reported receiving incorrect and very confusing denials from MedRisk, a managed care provider network, for bills that were actually submitted dir...

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