Request for Authorization
May 23, 2018
IMR Unlikely to Overturn UR Decisions
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...
Mar 2, 2018
FYI: $10k of Treatment Authorized Before Claim is Accepted or Denied
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...
Dec 14, 2017
In Workers' Comp, Authorization Is Final
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...
Dec 1, 2017
2018 Authorization/Utilization Review: Major Changes Effective 1/1/2018
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...
Aug 4, 2017
Why the RFA System Is Broken
Every day, we hear from frustrated providers across California who are struggling with their Requests for Authorization (RFAs). Their RFAs take too long to submit, and often ...
Mar 31, 2017
3DCA Decision Places Emphasis on RFA Timelines
On Wednesday afternoon, the California 3DCA, or Third District Court of Appeal, issued a ruling in the Ramirez v. Workers’ Compensation Appeals Board case. This is an interes...
Dec 9, 2016
Authorization and Declaration II: More on RFAs and Liens Under SB 1160
You already know Requests for Authorization (RFAs) as the single most effective tool for guaranteeing payment. Now RFAs play a vital role in lien declaration, as well....
Dec 2, 2016
A Year Later, San Bernardino Victims Face Work Comp Struggle
A flurry of recent media attention brought light to the struggle for treatment endured by victims of last year’s San Bernardino terrorist attack.¹ On the first anniversary of...
Jun 3, 2015
Questions and Answers about RFAs for Workers' Compensation
Today’s questions and answers come from our webinar on Requests for Authorization (RFAs). Why do we have so many webinars on RFAs? Because successful RFAs guarantee payment a...
Mar 16, 2015
WCAB RFA Cases and Why They Matter, Part II
In my last post I set out why I’m so enthusiastic about Requests for Authorization (RFAs). For those of you who want more detail, I’m going to summarize the act...
Aug 27, 2014
Workflow - Palooza! Request for Authorization and Second Bill Review
The workflows on here seem to be popular, so I’m posting a couple more from the webinars for Request for Authorization (RFA) and Second Bill Review (SBR). We have a lot of f...