PPO
Jul 18, 2025
Diabolical Discounts: Berkshire Hathaway's Reimbursement Roulette (Part 1)
A sad fact about California workers’ comp: once a doctor joins a Preferred Provider Organization (PPO), there’s no predicting how devastating the impact on practice revenue w...
Jul 16, 2025
Sedgwick: CA Doctors Still Waiting for Purloined PPO Reimbursement
In January, Sedgwick Claims Management Services, Inc. admitted to shortchanging a California orthopedic practice by hundreds of thousands of dollars—thanks to bogus Preferred...
Jun 20, 2025
City of Riverside Pays MD $31 by Triple-Stacking PPOs
This week’s Diabolical Discounter is the City of Riverside. This self-insured public employer slashed a doctor’s reimbursement for a municipal worker’s Evaluation and Managem...
Jun 13, 2025
Diabolical Discounts: CA Employers Are Getting Ripped Off
In California, doctors who treat injured workers are seeing their revenue collapse due to exploitative discount reimbursement schemes. California Senate Bill 863, whic...
Jun 10, 2025
Report: CA DIR Director Hagen Resigning
According to Workers’ Comp Executive, California Department of Industrial Relations (DIR) Director Katrina Hagen is stepping down after five years. The Californ...
May 28, 2025
Insurance Execs Make Bank While Comp Crumbles
Business Insurance recently named the five highest-paid executives in the country for 2024. These executives’ compensation packages are, as expected, massive—an...
May 16, 2025
Diabolical Discounts: Ralphs Pays MD $44 to Treat Injured Worker
Our weekly “Diabolical Discounts” features the most atrocious examples of the low reimbursements doctors receive for treating California’s injured workers.<...
May 13, 2025
Long Beach Pays CA Doctors Less Than Interpreters (and Plumbers)
Last week’s Diabolical Discounts revealed that the City of Long Beach paid a doctor just over $32 to treat an injured municipal employee. The article provoked outrage–and com...
May 9, 2025
Diabolical Discounts: Long Beach Pays Doctor $32 to Treat Injured Employee
Across the nation, providers struggle to treat injured workers without financially damaging their practices. The problem is especially ugly in California, where extrem...
May 2, 2025
Diabolical Discounts: Disney & MultiPlan Take 56% Off Provider's Bill
Across the nation, providers struggle to treat injured workers without financially damaging their practices. The problem is especially ugly in California, where extreme reimb...
May 1, 2025
Please Advise: An Open Letter to the CA DWC (cc: CA Attorneys)
We have a question for California’s Division of Workers’ Compensation (CA attorney comments are always welcomed, too): What should a medical practice do in the followi...
Apr 10, 2025
Sedgwick’s Shell Game: From Coventry to CareWorks, the Chicanery Continues
Sedgwick Claims Management Services, Inc., a Third-Party Administrator (TPA), appears to be throwing any available spaghetti at the wall to continue funneling e...