Network Discounts
Nov 16, 2021
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...
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...
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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...
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...
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...
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...
May 19, 2021
Anthem: PPO Discount 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.
May 11, 2021
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...
May 5, 2021
Athens Must Stop Taking Unnamed PPO Discounts
As advocates for a fair and just workers’ comp system, we here at DaisyBill feel compelled to remind insurer Athens Administrators of an important fact about California worke...
May 4, 2021
CCSF Stands Up On Behalf of Providers
Many payers delegate bill review to an outside entity, trusting the bill review vendor to properly reimburse providers. But when a provider disputes a denial or adjustment, i...
May 3, 2021
Prime Health: Unsigned Contract Tale Continues
Almost immediately after DaisyBill called out Prime Health Services (PHS) for questionable PPO practices, it was clear we struck a nerve. PHS attorneys sent DaisyBill a ‘plea...
Apr 27, 2021
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...