OMFS

Convoluted Coding: Applied Underwriters Tries to Shortchange Provider

For anyone concerned by the lack of providers willing to treat injured workers, the following dark tale perfectly illustrates the reason so many providers flee workers’ comp....

CA OMFS: Physician Services Fee Schedule Update Effective 10/1/2019

A new order from the Administrative Director of California’s Division of Workers’ Compensation (DWC) updates the Physician and Non-Physician Practitioner Services portion of ...

CA OMFS: DMEPOS Fee Schedule Update Effective 10/1/2019

In Newsline No.: 2019-75, the California Division of Workers’ Compensation (DWC) announced updates to the Official Medical Fee Schedule for Durable Medical Equipment, Prosthe...

CA OMFS Update: Pathology/Clinical Lab Fee Schedule for 7/1/2019

On July 8, 2019, California’s Division of Workers’ Compensation (DWC) ordered an update to the Pathology and Clinical Laboratory section of the Official Medical Fee Schedule ...

CA Physician MUE Reimbursement Change as of 7/1/2019

In Newsline No.: 2019-46, the California Division of Workers’ Comp (DWC) announced changes to the Official Medical Fee Schedule for Physician Services / Non-Physician Practit...

CA Physician Reimbursements INCREASE as of 7/1/2019

In Newsline No.: 2019-46, the California Division of Workers’ Comp (DWC) announced changes to the Official Medical Fee Schedule for Physician Services / Non-Physician ...

Alert: More Unreasonable Physician Reporting Demands

When it comes to billing complications, some California payers are demanding documentation for time-based procedure codes; a demand that is unsubstantiated by California work...

SB 537: Say NO to Medicare Reimbursements

A proposed California bill, though seemingly benign, may establish Medicare rates as a standard for workers’ comp reimbursements, which would be a mistake. The bill, w...

SCIF to Correct Payment Errors

California’s State Compensation Insurance Fund (SCIF) stepped up and promised to fix all bills affected by its mistaken use of the 2018 Official Medical Fee Schedule. ...

Assistant at Surgery: All You Need to Know

Last week, we opened Pandora’s box on co-surgeons and team surgery. Notably left in the box was a discussion on assistant(s) at surgery. Typically this arises when physicians...

📬 Payer Responses: Guile, Waiting, and Crickets 🏏

Today we report on the responses from Sedgwick, Liberty Mutual, York, and State Compensation Insurance Fund (SCIF), following our posts detailing their systematic underpaymen...

Co-Surgery vs. Team Surgery: All You Need to Know

Surgery in workers’ compensation cases opens a Pandora’s box: reserves go up, nurse case managers get involved, and surgeons need to justify every detail of their billing to ...