Blog: Daisy News

California’s Division of Workers’ Compensation (DWC) posted update orders to two sections of the Official Medical Fee Schedule (OMFS), both effective July 1, 2018.

The DWC ordered changes to the Physician and Non-physician Practitioner fee schedule, as well as the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule.

The orders affect reimbursement for 5 codes in total, 4 for Physician Services and one for DMEPOS.

If your office looked to the Lockard Industrial Insurance Companies’ List to find contact information for workers’ comp payors, you’ll need to look elsewhere.

The green spiral-bound book containing addresses, phone and fax numbers, and email addresses for almost every insurance and third party administrator in California is no more. Previously released annually with new information, the directory’s last edition was published in 2016. Like vinyl records and VHS, Lockard’s List was much loved, but ultimately outpaced by the Digital Age.

All information previously available in Lockard (and more) is available through DaisyBill’s Work Comp Wizard.

The Division of Workers' Compensation (DWC) posted a video replay of their recent webinar on the newly effective drug formulary. The DWC hosted the webinar in December, following the formulary's official state approval. For those who could not attend the webinar, the DWC initially posted a written transcript.

Technical problems at third-party administrator York Risk Services left roughly 15,000 bills unprocessed. The error was discovered and resolved by York’s in-house bill review, which is currently processing the affected bills. According to York representatives, it may take up to 30 days from their discovery of the glitch to complete the processing.

The glitch affected bills submitted by providers between October 27, 2017, and November 15, 2017.

Several providers recently received incorrect denials of bills from California’s State Compensation Insurance Fund (SCIF), the state’s largest provider of work comp insurance. These original bills were denied for untimely submission, despite having been submitted within the required timeline. Senate Bill 1175 mandates a 12-month deadline for original bill submission.

A SCIF representative acknowledged the error, as the insurer moved quickly to resolve it.

Last month, Division of Workers’ Compensation (DWC) hosted a detailed live webinar on the newly effective drug formulary. For those who could not attend the webinar, the DWC recently made available a full transcript, accessible from the DWC website.

The drug formulary is effective as of January 1, 2018.

Effective January 1, the employer County of Fresno transferred all claims from third-party administrator (TPA) Risico Claims Management, Inc. to Acclamation Insurance Management Services (AIMS). The change applies to all dates of service.  All claims transferred to AIMS retain the same claim numbers used under Risico.

Lately, we brought readers the Division of Workers’ Compensation (DWC)’s recent updates to the Physician fee schedule for evaluation & management and surgery. Today, we take a look at the new reimbursements for radiology services, effective January 1, 2018.

On January 16, we will host a comprehensive webinar covering all the changes to the OMFS. In the meantime, refer to the chart below for quick and easy reference. As always, DaisyBill clients can rest assured that our OMFS Calculator will include the most recent available reimbursement rates.