Maximus Federal Services
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 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...
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...