Maximus Federal Services
Jul 20, 2023
CA IBR: Why Are Claims Admins Redacted From Decisions?
Accountability is critical to the functioning of any system, especially one upon which the health of injured workers depends. So we’re compelled to ask a question that’s been...
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Jul 18, 2023
Untimely IBR Decisions - DWC Ignores CA Law
Recently, we shared the numbers demonstrating the absurd (and unlawful) lengths of time for which the Division of Workers’ Compensation (DWC) forces providers to wait for an ...
Jun 15, 2023
DWC Repeatedly Violates CA IBR Law
California fails to maintain a workers’ comp environment that’s fair and navigable for providers (you know, the people who treat the injured workers). Prime example: the Divi...
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...
Apr 19, 2022
Med-Legal IBR: Maximus Denies Documented Interpreter Reimbursement
In a perfect example of California’s failing Independent Bill Review (IBR) process, Maximus (California’s designated IBR organization) abandoned all semblance of lawfulness a...
Sep 22, 2021
Liberty Mutual Stiffs QME - Attorneys Required
Hello California Workers’ Comp Attorneys, Medical-Legal physicians in this state need your help. Payers like Liberty Mutual have found a way to skirt the Independent ...
Jul 6, 2021
IBR Hall of Shame: Sedgwick Sets New Standard of Noncompliance
Sedgwick failed to comply with an Independent Bill Review (IBR) ruling for almost four months. Worse, the payor’s brazenness is likely to go unpenalized by the state.T...
Jun 29, 2021
Med-Legal Bill Denied for Liability? Request IBR
Certain California workers’ comp payers deny reimbursement for Medical-Legal evaluations by claiming lack of liability for the initial injury. With this twisted, circular log...
Apr 5, 2021
City & County of San Francisco's Misleading Reply in PPO Dispute
Recently, a DaisyBill provider disputed a reduction in reimbursement from the City and County of San Francisco (CCSF) for treating an injured employee. In the Explanation of ...
Mar 5, 2020
California IBR Fee Reduced Effective January 2020
Finally, some good news about Independent Bill Review (IBR)! Effective January 1, 2020, the required filing fee for providers requesting IBR dropped from $195 to $180.
Nov 25, 2019
SCIF Tantrum Subverts the IBR Process
Few behaviors induce more cynicism than when claims administrators ask providers to withdraw requests for Independent Bill Review (IBR) in exchange for correct payment. Appar...
Nov 18, 2019
Victory for Providers: Maximus Rules on CPT 99358
*Update: The 2021 OMFS updates drastically changed how E/M codes are billed. The article below only applies to DOS before March 1, 2021.*In the past, DaisyBill has rep...