Second Review

CA Workers' Comp: Appeals Rigged to Profit Payers
Mar 21, 2022
CA Workers' Comp: Appeals Rigged to Profit Payers
When a claims administrator incorrectly reimburses a California workers’ comp provider, the mandated process for the provider to dispute the error (or purposeful theft) is co...
Athens Admin Pays $0.51 for Firefighter's Treatment
Feb 1, 2022
Athens Admin Pays $0.51 for Firefighter's Treatment
We do our best to give folks the benefit of the doubt here at daisyBill. However, we can only presume that Athens Administrators deemed the authorized treatment admini...
Costco: Helmsman Tries to Skirt Missed Appointment Fee
Jan 30, 2022
Costco: Helmsman Tries to Skirt Missed Appointment Fee
Denying payment to a Medical-Legal physician by falsely deeming a service non-compensable is a common — and contemptible —  transgression. But Helmsman Management Serv...
Berkshire Hathaway: DWC Targeted Audit Needed ASAP
Jan 13, 2022
Berkshire Hathaway: DWC Targeted Audit Needed ASAP
As Berkshire Hathaway HomeState Companies (BHHC) persists in its failure to compliantly process thousands of valid Second Review appeals, the California Divisio...
Berkshire Hathaway Ignores THOUSANDS of Second Review Appeals (& CA Law)
Jan 12, 2022
Berkshire Hathaway Ignores THOUSANDS of Second Review Appeals (& CA Law)
Berkshire Hathaway Homestate Companies (BHHC) continues to fail to compliantly process valid Second Review appeals submitted by California doctors to dispute erroneously deni...
Berkshire Hathaway Refuses 892 Second Review Appeals
Dec 7, 2021
Berkshire Hathaway Refuses 892 Second Review Appeals
Berkshire Hathaway hath a way of defying California workers’ comp regulations, and refusing to pay doctors for authorized treatment provided to in...
10 Ways to Fix CA Workers' Comp
Nov 30, 2021
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...
SCIF Hacks IBR by Switching (Incorrect) Denial Reason
Sep 15, 2021
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...
Sedgwick Denies Second Review Appeals as "Duplicates"
Jul 12, 2021
Sedgwick Denies Second Review Appeals as "Duplicates"
Sedgwick has a Second Review problem.On too many occasions, Sedgwick incorrectly denies providers’ Second Review appeals as “duplicate submissions” of the original bil...
City & County of San Francisco's Misleading Reply PPO Dispute
Apr 5, 2021
City & County of San Francisco's Misleading Reply PPO Dispute
Recently, a DaisyBill provider disputed a reduction in reimbursement from the City and County of San Francisco (CCSF) for treating an injured employee. In the Explanation of ...
Broadspire Knows No Law But Its Own
Apr 2, 2021
Broadspire Knows No Law But Its Own
Broadspire continues to break the rules, seemingly confident that California regulators will not hold the claims administrator to account. For months, we reported on B...
Broadspire Employers: Audit Complaint Filed With DWC
Oct 21, 2020
Broadspire Employers: Audit Complaint Filed With DWC
In a recent article, Broadspire Defies CA Law and Denies Appeals Sent by Providers, we described Broadspires’ success in defying California workers’ comp laws without consequ...