Independent Bill Review
Nov 30, 2021
10 Ways to Fix CA Workers' Comp
Today, the California Division of Workers’ Compensation (DWC) will host a virtual public meeting “to hear ideas to improve the efficiency and quality of care provided to inju...
Mar 30, 2021
Zurich Denies Liability After Accepting Liability
Zurich recently denied liability for an injured workers’ treatment, claiming the 2003 injury was not work-related — despite the fact that Zurich already authorized the treatm...
Mar 24, 2021
IBR Hall of Shame: Employers
Employers Holdings set a shameful new standard of indifference with regard to promptly and correctly reimbursing providers. The insurer incorrectly denied payment, disregarde...
Sep 15, 2020
AmTrust - IBR Hall of Shame
Below, we document the flouting of workers’ compensation law by AmTrust North America (AmTrust), and its continued refusal to reimburse a provider despite being ordered to do...
Aug 16, 2019
SCIF, CorVel IBR Withdrawal Requests Create ENORMOUS Hassles for Providers
The billing lesson for today: providers should never agree to withdraw a request for Independent Bill Review (IBR), no matter how sweetly the payor begs. Trust us; we’ve lear...
Mar 7, 2019
SCIF IBR Disputes Are Further Proof of Provider Reimbursement Chaos
We are again chronicling the reimbursement pandemonium inflicted on providers by the current California Second Review appeal and Independent Bill Review (IBR) processes.<...
Feb 15, 2019
Liberty Mutual Trifecta of Incorrect Payments
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...
Nov 8, 2018
CA Claims Admin Delays Payment, Skirts IBR Rules
When the Independent Bill Review (IBR) process overturns a claims administrator’s incorrect denial or adjustment, the claims administrator is legally bound to timely pay what...
Sep 25, 2018
IBR Accountability: Claims Admins Fail to Pay Providers
California regulations mandate that when Independent Bill Review (IBR) overturns a claims administrator’s incorrect bill denial or adjustment and finds in favor of the provid...
Sep 20, 2018
Maximus Blunders AGAIN with 99358 Decision and a Math Error
Maximus Federal Services, the entity responsible for conducting Independent Bill Review (IBR) on behalf of California’s Division of Workers’ Compensation (DWC), has once agai...
Aug 10, 2018
Maximus Creates IBR Delays With Impossible Demands
Maximus Federal Services, the private entity which conducts Independent Bill Review (IBR) on behalf of California’s Division of Workers’ Compensation (DWC), has always demons...
May 30, 2018
E/M Services Denied for Insufficient Documentation
Increasingly, claims administrators are no longer downcoding evaluation and management (E/M) services. Instead, many claims administrators are denying charges for E/M service...