PPO
May 10, 2022
PPO Discounts STILL NOT Applicable to Med-Legal
It’s hard to believe we still have to write this — or is it? California claims administrators may not apply Preferred Provider Organization (PPO) reductions to physici...
Apr 28, 2022
Mitchell Hustles for MPA, Insurance Co. of the West
California workers’ comp doctors, keep screening your phone calls. Mitchell International, on behalf of the Municipal Pooling Authority (MPA) and Insurance Company of the Wes...
Mar 22, 2022
PPO: No Provider Recourse for Unnamed Discounts
In California workers’ comp, the appeals process for disputing improper Preferred Provider Organization (PPO) reductions has a serious flaw.Routinely, Explanations of ...
Mar 16, 2022
How to Identify PPO Reductions (Part I)
Daily, we hear from workers’ comp providers requesting help with identifying whether Pilfering Provider Organizations (aka: PPOs) are hijacking the funds intended to pay for ...
Mar 14, 2022
PPOs Force Doctors to "Pay-to-Play"
Whether in business, politics, or sports, forcing professionals to pay for the privilege of simply doing their jobs (aka “pay-to-play”) is indefensible. But arguably, ...
Mar 8, 2022
Network CEO Exposes Triton/PCS Improper Discounts
In a revelation with severe implications for California workers’ comp, CEO Todd Breeden of America’s Choice Provider Network (ACPN) reported that Triton Healthc...
Mar 1, 2022
Triton Gouges Providers - Pays 78% of Medicare Rates
Triton Healthcare Partners and Apricus (formerly Preferred Care Solutions) are collaborating with other Preferred Provider Organization (PPO) entities to hijack payments from...
Feb 1, 2022
Athens Admin Pays $0.51 for Firefighter's Treatment
We do our best to give folks the benefit of the doubt here at daisyBill. However, we can only presume that Athens Administrators deemed the authorized treatment admini...
Jan 25, 2022
Anthem, CorCare Loot MD - Paying ONLY 5-6% OMFS
As employers vocally complain that their injured employees struggle to find doctors, California legislators allow Preferred Provider Organizations (PPOs) to reap huge profits...
Nov 30, 2021
10 Ways to Fix CA Workers' Comp
Today, the California Division of Workers’ Compensation (DWC) will host a virtual public meeting “to hear ideas to improve the efficiency and quality of care provided to inju...
Nov 17, 2021
Lien Chaos Returns: DWC Rules for Anthem (Part III)
California’s Division of Workers’ Compensation (DWC) has a duplicity problem. In the third chapter of our series on The Zenith and Anthem Blue Cross, we discover that ...
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...