Second Review
Nov 30, 2023
Alert: Sedgwick's Phantom Payment Reductions
Recently, Sedgwick Claims Management Services reduced a daisyBill doctor’s payments to 25% below the amount allowed by the California Physician Fee Schedule. To justify the r...
Sep 19, 2023
daisyBill Account Analytics: Appeal Payments!
If no one tracks your workers’ comp bills, you’re probably missing critically important information about your practice’s revenue.The sad fact is that between i...
Aug 8, 2023
TRPN: How to Fight the Network's Discounts
We’ve warned providers about the disturbing practices of Three Rivers Provider Network (TRPN).* We’ve also written about how providers may be able to demand that TRPN termina...
Jul 26, 2023
Tristar Flouts Law - How Long Will IBR Take?
Tristar Risk Management seems extra comfortable ignoring payment laws and regulations, even by the woeful standards of California workers’ comp. As a result, daisyCollect has...
Jul 17, 2023
Tristar Ignores CA Second Review Law
We don’t need further evidence that California workers’ comp is corrupted beyond any reasonable person’s notions of fairness, justice, or equity — but here’s Tristar Risk Man...
May 15, 2023
SCIF Makes Mockery of IBR and the DWC
Yet again, we face another appalling round of "IBR Chicken,” the game in which a claims administrator refuses to shell out a dime to a California provider for services render...
Mar 15, 2023
CPT 99358 & 99359: How to Appeal Payment Denials
In workers’ comp billing, some procedure codes are trickier than others.Two of the best examples are CPT codes 99358 and 99359, used by providers to report prolonged n...
Dec 8, 2022
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...
Oct 6, 2022
Practice Recovers $1 Million Annually via Second Review Appeals
It’s official: daisyBill providers have recovered over $100 million in revenue by electronically submitting Second Review appeals to dispute incorrect reimbursements f...
Sep 7, 2022
CA SCIF Baits & Switches MD Out of Payment
Once again, California’s State Compensation Insurance Fund (SCIF) may profit by exploiting a flaw in California’s Independent Bill Review (IBR) system.SCIF initially d...
Jun 28, 2022
Sedgwick Asserts CA "Loosened" Appeal Process
California workers' comp is — supposedly — governed by laws, enacted by the state legislature, and carried out by the Division of Workers’ Compensation (DWC). For disputes ov...
Jun 28, 2022
Data: Sedgwick Fails to Process 16,261 Second Review Appeals
Third-Party Administrator (TPA) Sedgwick Claims Management Services consistently ignores California workers’ comp requirements for properly responding to Second Review appeal...