PPO

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...

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...

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...

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...

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...

Sedgwick Owes Practice Over $570K…Has Paid Just $12K

Readers may recall last year’s daisyNews report on how Third-Party Administrator (TPA) Sedgwick Claims Management Services, Inc. underpaid a California orthopedic provider by...

Paduda's Predictions: An Insult to Workers’ Comp Doctors

Joe Paduda of Managed Care Matters is (understandably) worried about Americans losing their health insurance due to Republicans' cuts to healthcare spending—but his ar...

Sedgwick Stiffs CA Practice for Over $300,000

In California, claims administrators can siphon staggering amounts of revenue from practices using invalid Preferred Provider Organization (PPO) discounts—and doctors have no...

Medicare Advantage & Workers' Comp: Why Providers Reject Both

Becker’sreports that hospitals and health systems across the nation are giving up on Medicare Advantage, terminating contracts and refusing to treat patients co...

No, Doctors Aren't the Culprits in CA Workers' Comp

It’s time to take a sledgehammer to one of the most pernicious myths about workers’ comp in California. For decades, the Division of Workers’ Compensation (DWC) has fed legis...

Apricus Applies Massive, Invalid PPO Discount for Sedgwick

Specialty network vendor Apricus, acting on behalf of Third-Party Administrator (TPA) Sedgwick, recently applied an invalid Preferred Provider Organization (PPO) discount to ...

Gallagher Bassett Shows MPNs Are a Painful Waste

A recent exchange between a provider and Gallagher Bassett offers a perfect example of why California’s Medical Provider Network (MPN) system is a pointless, convoluted, unna...