Network Discounts
CA OMFS: E/M Reimbursement vs Medicare Reimbursement
Jun 8, 2022
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...
Network CEO Exposes Triton/PCS Improper Discounts
Mar 8, 2022
Network CEO Exposes Triton/PCS Improper Discounts
In a revelation with severe implications for California workers’ comp, CEO Todd Breeden of America’s Choice Provider Network (ACPN) reported that Triton Healthc...
Homelink Introduces 2% Paper Billing Fee
Feb 6, 2022
Homelink Introduces 2% Paper Billing Fee
Even before factoring in supplies, lost paperwork, and wasted time, the cost of sending non-electronic workers’ compensation bills is climbing. As of February 1, netwo...
Coventry Network: Non-Physician Providers Cost Less
Jan 31, 2022
Coventry Network: Non-Physician Providers Cost Less
Workers’ comp is in crisis. Doctors are fleeing the system, leaving employers and injured workers an increasingly smaller pool from which to seek care. For doctors, th...
Lien Chaos Returns: DWC Rules for Anthem (Part III)
Nov 17, 2021
Lien Chaos Returns: DWC Rules for Anthem (Part III)
California’s Division of Workers’ Compensation (DWC) has a duplicity problem. In the third chapter of our series on The Zenith and Anthem Blue Cross, we discover that ...
PPO Punishment: Zenith Boots Doctor From MPN per Anthem (Part II)
Nov 16, 2021
PPO Punishment: Zenith Boots Doctor From MPN per Anthem (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...
How Zenith & Anthem Swiped a Doctor's Revenue (Part I)
Nov 15, 2021
How Zenith & Anthem Swiped a Doctor's Revenue (Part I)
This is Part I of our three-part series on one California doctor’s struggle to protect practice revenue from an unsubstantiated Anthem PPO discount.Anthem Blue Cross e...
PPO vs Network: Who's Taking Your Money?
Nov 10, 2021
PPO vs Network: Who's Taking Your Money?
We’ve told the story many times: a doctor signs a discount contract, hoping to bring in more patients. Almost immediately, revenue for treating injured workers is down across...
Data: Drastic PPO Discounts Revealed
Sep 13, 2021
Data: Drastic PPO Discounts Revealed
It’s time to reveal what’s really harming injured workers in California. Starting today, DaisyBill will publicize the reduced reimbursement rates foisted on our provid...
Med-Legal: PPO Discounts Do NOT Apply to MLFS
Aug 17, 2021
Med-Legal: PPO Discounts Do NOT Apply to MLFS
Preferred Provider Organization (PPO) and other network discounts do not apply to the Medical-Legal Fee Schedule (MLFS). Period.In other words, the MLFS and OMFS are c...
SB 537 Reveals Murky World of Discount Contracts
Jun 30, 2021
SB 537 Reveals Murky World of Discount Contracts
In 2019, California passed Senate Bill 537. Among the changes to take effect on July 1st is a disclosure mandate requiring discount contracting entities to disclose to the cl...
Anthem:  PPO Discounts Result in Payments BELOW Medicare
May 19, 2021
Anthem: PPO Discounts Result in Payments BELOW Medicare
Q:  How much can a workers’ comp provider lose by signing a Preferred Provider Organization (PPO) agreement?A:  Much, much more than the provider probably realizes.