Preferred Provider Organization

Former PPO Employee: "I Felt Like I Was 'Legally' Robbing" Doctors

Prime Health Services (PHS) operates like a high-pressure "call center," pushing employees to sign providers onto reimbursement discount contracts by making promises t...

CA: How to Challenge PPO Discounts

California providers, if you suspect a reimbursement discount is invalid, you have the right to demand proof of an applicable discount contract.As we detailed last wee...

daisyData: CA Providers Paid at Fractions of Fee Schedule Rates

As daisyNews recently demonstrated with current, verifiable data:California’s workers’ comp fee schedule is one of the lowest nationwide, andData from ov...

Taxpayers Beware: Anaheim Misreports Payment Data

Citizens of Anaheim, CA, may want to examine the city’s books closely, given the suspicious accounting of taxpayer dollars designated for the care...

CA Employers: Comp Premium Hike Based On Bad Data

While most states are lowering employers’ workers’ comp premiums, California is heading in the opposite direction. Insurance Commissioner Ricardo Lara approved a premium rate...

Diabolical Discounts: Rampant Anthem PPO Carnage

Preferred Provider Organization (PPO) Anthem Blue Cross is enabling egregious abuse of California providers at scale. Since June, dozens of claims administrators have ...

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...