medical-legal
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...
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...
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...
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...
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...
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 ...
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.
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...
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...
Sep 7, 2022
IBR: Sedgwick Ordered to Pay QME $20k+ for False Med-Legal Denial
Sedgwick Claims Management Services just set a dubious new record. Maximus, the entity which conducts Independent Bill Review (IBR) on behalf of California’s Division of Work...
Aug 11, 2022
ESIS: 10 Audit Complaints Filed With CA DWC
California law requires claims administrators to send an Explanation of Review (EOR) and payment to the physician within 60 days of receiving a bill for Medical-Legal service...
Aug 11, 2022
Warning: ESIS (Still) Ignoring CA Medical-Legal Bills
How else can we put this? Sometimes ESIS, a Third-Party Administrator (TPA), just flat-out ignores bills for Medical-Legal services. Below, daisyBill documents how ESI...