MPN
Jan 26, 2023
Forbes Fluff Distorts CA Workers' Comp Realities
The good folks at Forbes recently offered California doctors and injured workers a slap in the face, in the form of a political fantasy narrative thinly veiled as an objectiv...
Dec 14, 2022
Can CA (or Anyone) Trust CareWorks?
CareWorks, a Managed Care Organization (MCO) that offers services such as bill review, utilization review, and “physician network services,” is in legal hot water with the St...
Dec 8, 2022
Providers Respond: How to Fix CA Workers' Comp
In advance of the public meeting recently held by the Division of Workers’ Compensation (DWC), daisyBill offered a few suggestions for improving California’s workers’ comp sy...
Dec 5, 2022
CA Providers Unite! Suggestions for the DWC
On December 6, 2022, California’s Division of Workers’ Compensation (DWC) invites stakeholders to a public meeting to share “ideas to improve the State’s worker...
Dec 1, 2022
MPN Chaos: Trader Joe's Employee Denied QME Treatment
Third-Party Administrator (TPA) Sedgwick Claims Management Services, acting on behalf of ACE American Insurance Company, refused to consider authorizing care recommend...
Dec 1, 2022
Sedgwick Uses Terminated ACE American MPN to Deny Payment
The Medical Provider Network (MPN) system in California is so chaotic, even the adjusters can’t keep up.For example: Third-Party Administrator (TPA) Sedgwick Claims Ma...
Dec 1, 2022
MPN Chaos: Sedgwick Denies QME Payment - Lowe's Home Center
The Medical Provider Network (MPN) system in California is out of whack — to the point that it breeds the kind of improper payment denials that make it impossible not to ask ...
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Nov 29, 2022
CA: Sedgwick Stiffs Doctor Who Treated Injured Honda Worker
The Medical Provider Network (MPN) system in California is chaos — and chaos breeds the kind of abuse that is currently crippling workers’ comp.Case in p...
Nov 2, 2022
MPNs: How to Detect Dubious Payment Denials
In California workers’ comp, one of the biggest — but least talked about — challenges for providers is navigating the Medical Provider Network (MPN) system. MPNs were ...
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 ...
Nov 2, 2022
Employers Insurance: False MPN Payment Denial
California allows insurers and self-insured employers to establish Medical Provider Networks (MPNs) to direct injured workers’ care. While Employers Preferred Insurance Compa...
Nov 2, 2022
Gallagher Bassett: False MPN Denial
In yet another instance of a claims administrator improperly denying payment because the provider was (allegedly) not a member of the applicable Medical Provider Network (MPN...