medical-legal
Med-Legal IBR Data: A Bad Look for Sedgwick & CA
Jan 30, 2023
Med-Legal IBR Data: A Bad Look for Sedgwick & CA
California appears to turn a willfully blind eye to what seems like an abuse of the Independent Bill Review (IBR) system for Medical-Legal disputes.Data ...
Forbes Fluff Distorts CA Workers' Comp Realities
Jan 26, 2023
Forbes Fluff Distorts CA Workers' Comp Realities
The good folks at Forbes recently offered California doctors and injured workers a slap in the face, in the form of a political fantasy narrative thinly veiled as an objectiv...
WCF Falsely Demands QME Refund
Dec 14, 2022
WCF Falsely Demands QME Refund
A friendly reminder to all California Qualified Medical Evaluators (QMEs) and Agreed Medical Evaluators (AMEs): when a claims administrator demands a refund of reimbursement ...
Med-Legal Data: IBR Is the QME/AME's Friend
Dec 8, 2022
Med-Legal Data: IBR Is the QME/AME's Friend
California workers’ comp presents serious challenges to physicians — and Medical-Legal physicians are no exception. Despite a recently simplified Medical-Legal Fee Sch...
CA QME Calls Out Cannon Cochran "Abuse and Insults"
Dec 8, 2022
CA QME Calls Out Cannon Cochran "Abuse and Insults"
A California Qualified Medical Evaluator (QME) has had quite enough nonsensical reimbursement games from Cannon Cochran Management Services, Inc. (CCMSI).The Third-Par...
CA Med-Legal: Q&A for Confused Physicians
Nov 8, 2022
CA Med-Legal: Q&A for Confused Physicians
Recently, a physician evaluator reached out to us with questions regarding Medical-Legal services for California workers’ comp. Rather than share the answers with this physic...
Midwest Insurance Fails to Pay QME
Nov 8, 2022
Midwest Insurance Fails to Pay QME
If there’s any doubt regarding why California workers’ comp is facing a shortage of Qualified Medical Evaluators (QMEs), look no further than Midwest Insurance. Midwest has b...
ALERT: Municipal Pooling Authority Bounces QME Check (Twice)
Nov 8, 2022
ALERT: Municipal Pooling Authority Bounces QME Check (Twice)
The Municipal Pooling Authority (MPA) recently bounced a check to a California Qualified Medical Evaluator (QME) — not once, but twice. According to MPA representative...
Sedgwick Stiffs QME With False MPN Denial (Again)
Nov 2, 2022
Sedgwick Stiffs QME With False MPN Denial (Again)
It’s been said that insanity is best defined by doing the same thing repeatedly, but expecting different results. If that’s the case, Sedgwick Claims Management Services has ...
DWC Proposes More Time to Schedule QME Appointment
Oct 6, 2022
DWC Proposes More Time to Schedule QME Appointment
California’s Division of Workers’ Compensation (DWC) will hold a public hearing on significant proposed changes to the regulations governing Medical-Legal evaluations.
WCIRB Report Obscures CA Workers' Comp's Real Challenges
Oct 4, 2022
WCIRB Report Obscures CA Workers' Comp's Real Challenges
A report from the Workers’ Compensation Insurance Rating Bureau (WCIRB) of California asserts that in 2021, “overall medical payments per claim increased significantly.” Howe...
ESIS Pays Med-Legal Bills Following Audit Complaints
Sep 7, 2022
ESIS Pays Med-Legal Bills Following Audit Complaints
California physicians can always rely on ESIS to pay its bills for Medical-Legal services — as long as they're willing to report ESIS to the Division of Workers’ Compensation...