PPO

PPOs Force Doctors to "Pay-to-Play"
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, ...
Network CEO Exposes Triton/PCS Improper Discounts
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...
Triton Gouges Providers - Pays 78% of Medicare Rates
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...
Athens Admin Pays $0.51 for Firefighter's Treatment
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...
Anthem, CorCare Loot MD - Paying ONLY 5-6% OMFS
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...
10 Ways to Fix CA Workers' Comp
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...
Lien Chaos Returns: DWC Rules for Anthem (Part III)
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 ...
Zenith Boots Doctor From MPN per Anthem PPO (Part II)
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...
How Zenith & Anthem Swiped a Doctor's Revenue (Part I)
Nov 15, 2021
How Zenith & Anthem Swiped a Doctor's Revenue (Part I)
This is Part I of our three-part series on one California doctor’s struggle to protect practice revenue from an unsubstantiated Anthem PPO discount.Anthem Blue Cross e...
AIG & Coventry (and California) Squeeze QME
Nov 4, 2021
AIG & Coventry (and California) Squeeze QME
California Medical-Legal physician evaluators, be advised: some payers still attempt to improperly apply Preferred Provider Organization (PPO) discounts to Medical-Legal bill...
Data: Discount Entities Plunder CA OMFS
Nov 2, 2021
Data: Discount Entities Plunder CA OMFS
Workers’ comp payers throughout California ignore the state fee schedule and fail to reimburse providers the mandated reimbursements rates as allowed by the sta...
PPO Data Update: The Toll on CA Doctors Who Treat Injured Workers
Sep 29, 2021
PPO Data Update: The Toll on CA Doctors Who Treat Injured Workers
DaisyBill’s California OMFS Reimbursement Reduction page tracks in minute detail the data around Preferred Provider Organization (PPO) and other discount contracts. Now, we’v...