Request for Authorization

Sedgwick Authorization Sewer - Why CA Needs UR Reform

An injury occurs at work. The injured worker sees a doctor. The doctor concludes that the worker needs a consultation from a specialist. Per California law, the treating doct...

Providers Respond: How to Fix CA Workers' Comp

In advance of the public meeting recently held by the Division of Workers’ Compensation (DWC), daisyBill offered a few suggestions for improving California’s workers’ comp sy...

CA Providers Unite! Suggestions for the DWC

On December 6, 2022, California’s Division of Workers’ Compensation (DWC) invites stakeholders to a public meeting to share “ideas to improve the State’s worker...

How "Fast-Track" UR Can Backfire for CA Providers

California’s “Fast-Track” Utilization Review (UR) initially sounded like good news for doctors who provide the first treatment following a work-related injury. ...

Sedgwick: Gruesome and Abusive IBR Games

In California workers’ comp, providers cannot rely on authorization to guarantee payment — despite what the law says. Today’s article shows exactly how a claims administrator...

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...

The Hartford Ignores TWO California Laws

By insisting The Hartford owed no payment for authorized treatment provided outside the Medical Provider Network (MPN), The Hartford pooh-poohed a clear-cut Cal...

Zurich Refuses to Pay for Emergency Treatment

In a medical emergency, a doctor treats first and asks questions later. But in response to a medical emergency, Zurich refused to pay a doctor for suturing a lacerated finger...

Dollar Tree/Sedgwick Won’t Pay for Authorized Treatment

Authorization is, by definition, a promise.It’s the promise that, once a doctor obtains authorization from an employer to treat an injured worker, the employer will pa...

SCIF Hacks IBR by Switching (Incorrect) Denial Reason

There’s a serious inequity in the appeals process by which California workers’ comp providers can dispute incorrect reimbursement for authorized treatment. State Compensation...

CA: Authorization for Treatment Provided via Telehealth

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

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