PPOs
Apr 18, 2024
C'mon, Sedgwick: TPA Tries PPO Discount for Med-Legal (Again)
We’ll say it as often as we have to: Preferred Provider Organization (PPO) discounts do not apply to bills for Medical-Legal services. It’s a lesson that Sedgwick Clai...
Mar 5, 2024
PPOs Undermine CA Physician Fee Schedule Increase
California’s Division of Workers’ Compensation (DWC) increased reimbursement rates under the Physician and Non-Physician Practitioner portion of the Official Medical Fee Sche...
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Dec 13, 2023
AmTrust Pays Physician FAR Less Than Interpreter
Why do California doctors refuse to treat injured workers? Today’s story offers a giant, unmistakable clue.For the same encounter with an injured worker, AmTrust North...
Nov 13, 2023
Prime Health PPO: 2024 Medicare Cuts May Decrease Workers' Comp Reimbursement
The Centers for Medicare and Medicaid Services (CMS) announced it will cut reimbursement rates for physician services in 2024 by 3.4%.This Medicare reimbursemen...
Oct 10, 2023
PPO: Why Your Practice Should Renegotiate (or Cancel) Discount Contracts
Preferred Provider Organizations (PPOs) are choking the financial life out of providers who treat injured workers. This problem is being reported by doctors throughout...
Mar 9, 2023
Webinar: Are PPOs Pillaging Your Practice?
The live webinar has ended; stay tuned to this space for access to the video replay.Throughout the United States, Preferred Provider Organizations (PPOs) are taking ma...
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Nov 10, 2021
PPO vs Network: Who's Taking Your Money?
We’ve told the story many times: a doctor signs a discount contract, hoping to bring in more patients. Almost immediately, revenue for treating injured workers is down across...
Aug 17, 2021
Med-Legal: PPO Discounts Do NOT Apply to MLFS
Preferred Provider Organization (PPO) and other network discounts do not apply to the Medical-Legal Fee Schedule (MLFS). Period.In other words, the MLFS and OMFS are c...
May 19, 2021
Anthem: PPO Discount Payments BELOW Medicare
Q: How much can a workers’ comp provider lose by signing a Preferred Provider Organization (PPO) agreement?A: Much, much more than the provider probably realizes.
May 5, 2021
Athens Must Stop Taking Unnamed PPO Discounts
As advocates for a fair and just workers’ comp system, we here at DaisyBill feel compelled to remind insurer Athens Administrators of an important fact about California worke...
May 4, 2021
CCSF Stands Up On Behalf of Providers
Many payers delegate bill review to an outside entity, trusting the bill review vendor to properly reimburse providers. But when a provider disputes a denial or adjustment, i...
May 3, 2021
Prime Health: Unsigned Contract Tale Continues
Almost immediately after DaisyBill called out Prime Health Services (PHS) for questionable PPO practices, it was clear we struck a nerve. PHS attorneys sent DaisyBill a ‘plea...