Blog: DaisyNews

Workers' Comp News, Data, and Insights

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CA: Authorization for Treatment Provided via Telehealth

Apr 24, 2020

When we published Telehealth Cheat Sheet: California Providers’ Guide, many providers reached out to us with questions regarding authorization requirements. For clarification...

Ease Authorization Requirements for Workers' Comp During COVID-19

Apr 9, 2020

For California providers, obtaining authorization for workers’ compensation treatment requires substantial administrative resources. As COVID-19 strains those resources, prio...

California - 3 Workers' Comp Authorization Myths, Debunked

Feb 18, 2020

Providers who treat injured workers have one simple, reasonable request: correct reimbursement. In helping providers to obtain correct reimbursement, we answer a daily...

Maximus & DWC Drop Ball on IBR Eligibility

Oct 22, 2019

California workers’ comp billing and payment regulations are a minefield of complications. That said, some rules are fairly simple, and should be immutable. For exampl...

CA: Employers 100% Responsible for UR Mistakes

Oct 12, 2018

In a much-anticipated ruling, California’s Supreme Court ruled that a secondary injury derived from an incorrect Utilization Review (UR) decision is compensable under workers...

Conditional Authorization: How MPNs Cheat Workers’ Comp Providers

Jun 22, 2018

Medical Provider Networks (MPNs) are a drag on California workers’ compensation. Nominally designed to help employers control costs, MPNs rarely achieve more than throwing up...

Data Show MPNs Do Not Benefit Employers

Jun 20, 2018

Medical Provider Networks (MPNs) allow employers to limit where employees may seek treatment for work-related injuries. Theoretically, the purpose of MPNs is to direct care w...

Do Not Send RFAs With Bills

Jun 6, 2018

When treating an injured worker, a provider must fax the Request for Authorization (RFA) to the fax number designated by the claims administrator. RFAs should never be sent w...

IMR Unlikely to Overturn UR Decisions

May 23, 2018

When a payor’s utilization review organization (URO) denies treatment recommended by an injured worker’s treating physician, the only recourse is for the injured worker to ap...

FYI: $10k of Treatment Authorized Before Claim is Accepted or Denied

Mar 2, 2018

When an employee files a workers’ compensation claim, the employer or insurer is immediately liable for the cost of all medically necessary treatment provided before the clai...

In Workers' Comp, Authorization Is Final 

Dec 14, 2017

Let’s be very clear: in the workers’ comp dialect of Legalese, “authorization” means guaranteed payment for approved services. Period.While one can imagine scenarios i...

2018 Authorization/Utilization Review: Major Changes Effective 1/1/2018

Dec 1, 2017

Senate Bill 1160 makes significant changes to the authorization and utilization review (UR) process starting in 2018. New “fast-track” UR takes effect on January 1. Fa...

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