Maximus Federal Services
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 and County of San Francisco's Misleading Response in PPO Discount 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...
Oct 22, 2019
Maximus & DWC Drop Ball on IBR Eligibility
California workers’ comp billing and payment regulations are a minefield of complications. That said, some rules are fairly simple, and should be immutable. For exampl...
Oct 3, 2019
Liberty Mutual and a Cautionary Tale of Payment Woes
Today we’re sharing a maddening and all-too-common story of payment woes, this time featuring Liberty Mutual as the miscreant that just won’t pay a bill correctly -- despite ...
Sep 4, 2019
Liberty Mutual, Gallagher Bassett, Chubb Scoff at CA IBR Rules
It’s still happening: claims administrators including Liberty Mutual, Gallagher Bassett, and Chubb are ignoring the rules regarding Independent Bill Review (IBR), brazenly re...
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...
Apr 17, 2019
Liberty Mutual IBR Noncompliance: Unfair and Odious
After 124 days and 13 phone calls, Liberty Mutual fails to pay a $195 IBR fee ordered by Maximus. Employers need to take heed of this unlawful tale and make sure that ...
Feb 12, 2019
Maximus Confirms Using Second Review Appeals to Correct Billing Errors
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...