MLFS

CA: Med-Legal Makes More Financial Sense Than Treatment
Jan 30, 2024
CA: Med-Legal Makes More Financial Sense Than Treatment
California physicians must come to terms with an uncomfortable fact: financially, a physician’s time is much better spent conducting Medical-Legal evaluations than actually t...
Sedgwick Loses IBR (But Still Wins "IBR Chicken")
Apr 21, 2023
Sedgwick Loses IBR (But Still Wins "IBR Chicken")
You can’t say we didn’t try.Earlier this month, we offered Third-Party Administrator (TPA) Sedgwick Claims Management Services, Inc. 100% free use of our daisyWizard f...
Sedgwick, Please Accept a Free Gift From daisyBill
Apr 6, 2023
Sedgwick, Please Accept a Free Gift From daisyBill
Sedgwick Claims Management Services, daisyBill is here for you.We notice that you struggle mightily with correctly calculating reimbursements under California’s...
The Hartford Fails Med-Legal 101 (F-)
Mar 17, 2023
The Hartford Fails Med-Legal 101 (F-)
Workers’ comp insurer The Hartford has a few very basic things to learn about Medical-Legal evaluations in California. Namely, that initial evaluations generally prece...
(Free, Transparent) CA Med-Legal Fee Schedule Data
Aug 4, 2022
(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...
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...
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: $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...
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...
CA Med-Legal Reports: REQUIRED Physician Verification
Feb 7, 2022
CA Med-Legal Reports: REQUIRED Physician Verification
Last spring, California introduced a new Medical-Legal Fee Schedule (MLFS). Since April 2021, daisyBill clients have submitted over 80,000 medical-legal bills where the new M...