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medical-legal
Sep 7, 2022
3 min read
0
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
5 min read
0
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
5 min read
0
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...
Aug 4, 2022
3 min read
0
(Free, Transparent) CA Med-Legal Fee Schedule Data
As the California Workers’ Compensation Institute (CWCI) peddles paid access to its insurer-derived data and white-tie webinars, daisyBill would like to offer an update on th...
Jul 27, 2022
3 min read
0
CA Med-Legal Fees, QMEs Under Attack
A recent study on the current Medical-Legal Fee Schedule (MLFS) has triggered a wave of pearl-clutching by payer advocates. So what has the payer-side pundits groping for the...
Jul 13, 2022
2 min read
0
DWC Seeks QMEs for October Exam
California’s Division of Workers’ Compensation (DWC) is accepting applications from physicians for the October 2022 Qualified Medical Evaluator (QME) exam.The in-perso...
May 10, 2022
3 min read
0
Med-Legal: Cannon Cochran Denies Payment for Interpreter Services
Medical-Legal physician evaluators, be advised: a disturbing payment denial tactic is catching on among California claims administrators. When responding to physician ...
May 10, 2022
2 min read
0
Free: CA Med-Legal "Superbills"
Medical-Legal billing for California workers’ comp is fraught with complications, contradictions, and — of course — threats to physician revenue from less-than-scrupulous ent...
May 10, 2022
2 min read
0
PPO Discounts STILL NOT Applicable to Med-Legal
It’s hard to believe we still have to write this — or is it? California claims administrators may not apply Preferred Provider Organization (PPO) reductions to physici...
Apr 27, 2022
3 min read
0
CA Med-Legal How-To: Collect Penalty & Interest Payments
California physician evaluators, be advised: when claims administrators are late in paying for Medical-Legal services, penalty and interest payments apply. However, inadequat...
Apr 27, 2022
3 min read
0
CA Med-Legal: $76 Million Owed For Record Review in First Year
It’s been just over a year since California adopted the new Medical-Legal Fee Schedule (MLFS). Effective April 1, 2021, the new MLFS represented the first incre...
Apr 21, 2022
3 min read
0
ESIS Continues to Refuse Payment for Med-Legal Evaluations
Third-party claims administrator (TPA) ESIS systematically refuses to pay bills for Medical-Legal services. Full stop. Below, we list 9 Medical-Legal bills — some more...
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