MPN

CA OMFS: E/M Reimbursement vs Medicare Reimbursement

California workers’ comp allows discount networks to bleed the doctors who treat injured workers. Unfortunately for these workers and their employers, many of these financial...

Claims Admin Directory: FREE MPN Info Added!

In California workers’ comp, the Medical Provider Network (MPN) system is confusing and convoluted — largely by design. It is nearly impossible for doctors to locate i...

CA MPNs: 10 Facts About Monetized Provider Networks

It is crucial for doctors to understand both how California Medical Provider Networks (MPNs) operate to restrict doctors from treating injured workers and how some “entities”...

PPOs Force Doctors to "Pay-to-Play"

Whether in business, politics, or sports, forcing professionals to pay for the privilege of simply doing their jobs (aka “pay-to-play”) is indefensible. But arguably, ...

10 Ways to Fix CA Workers' Comp

Today, the California Division of Workers’ Compensation (DWC) will host a virtual public meeting “to hear ideas to improve the efficiency and quality of care provided to inju...

Zenith Boots Doctor From MPN per Anthem PPO (Part II)

Our tale of one doctor’s struggle with the Anthem Blue Cross Preferred Provider Organization (PPO) took a disturbing — if predictable — turn.Despite a doctor’s request...

The Hartford Ignores TWO California Laws

By insisting The Hartford owed no payment for authorized treatment provided outside the Medical Provider Network (MPN), The Hartford pooh-poohed a clear-cut Cal...

Zurich - An Example of California's MPN Shell Game

Where opacity and obfuscation reign, injustice thrives. There may be no better example of this than California’s Medical Provider Network (MPN) system. T...

MPNs: The Jekyll and Hyde of Workers' Comp

We’ve argued that MPNs are mostly a drag on the workers’ compensation system. But as some employers demonstrate, they don’t have to be.When employers use MPNs to maint...

Anthem/SCIF: MPN Kickback Scheme?

Healthcare software firm CareCloud recently agreed to a $3.8 million settlement, in part to resolve allegations that it traded unlawful payments for referrals, in violation o...

California MPNs: Camouflage for Discounts and Denials

Medical Provider Networks (MPNs) are under fire — as they should be.Far too often, Calforina claims administrators (aka ‘payers’) use MPNs — and providers’ unfamiliari...

Payola? SCIF / Anthem Coordinate Provider MPN Shakedown

State Compensation Insurance Fund (SCIF) and Anthem Blue Cross (Anthem) have hacked the Medical Provider Network (MPN) system to apparently shake down providers. A recent ema...