medical-legal

CA Med-Legal Fees, QMEs Under Attack
Jul 27, 2022
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...
DWC Seeks QMEs for October Exam
Jul 13, 2022
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...
Med-Legal: Cannon Cochran Denies Payment for Interpreter Services
May 10, 2022
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 ...
Free: CA Med-Legal "Superbills"
May 10, 2022
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...
PPO Discounts STILL NOT Applicable to Med-Legal
May 10, 2022
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...
CA Med-Legal How-To: Collect Penalty & Interest Payments
Apr 27, 2022
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...
CA Med-Legal: $76 Million Owed For Record Review in First Year
Apr 27, 2022
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...
Med-Legal IBR: Maximus Denies Documented Interpreter Reimbursement
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...
CA Med-Legal: How to Appeal Unpaid AME Modifier -94
Apr 7, 2022
CA Med-Legal: How to Appeal Unpaid AME Modifier -94
Regularly, California workers’ comp claims administrators incorrectly deny Medical-Legal Fee Schedule (MLFS) modifier -94 for Agreed Medical Evaluator (AME) services. In this...
Farmers Insurance: Winning "IBR Chicken”
Mar 31, 2022
Farmers Insurance: Winning "IBR Chicken”
California workers’ comp technically offers an appeals process for providers to dispute incorrect reimbursements. However, this appeals process actually encourages claims adm...
ESIS Unpaid Medical-Legal Bills
Mar 29, 2022
ESIS Unpaid Medical-Legal Bills
Alert: ESIS has failed to pay at least 7 bills for workers’ comp Medical-Legal services, despite acknowledging receipt of the bills in question. Further, attempting to...
CA Med-Legal: How to Bill for 10K+ Pages/Units of MLPRR
Feb 10, 2022
CA Med-Legal: How to Bill for 10K+ Pages/Units of MLPRR
To help demystify California Medical-Legal record review billing code MLPRR, daisyBill published an MLPRR guide for California physician evaluators. Our ...