medical-legal

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

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

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)

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)

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

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

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

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...

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...

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...

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...

(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...