Second Review
Sedgwick Asserts CA "Loosened" Appeal Process
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...
Data: Sedgwick Fails to Process 16,261 Second Review Appeals
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...
Audit Complaint: Sedgwick 16,261 Noncompliant Second Review Responses
Jun 28, 2022
Audit Complaint: Sedgwick 16,261 Noncompliant Second Review Responses
Using data generated by tens of thousands of electronic bills sent by our provider clients, daisyBill has demonstrated consistent non-compliance with California e-billing reg...
Farmers Insurance: Winning "IBR Chicken”
Mar 31, 2022
Farmers Insurance: Winning "IBR Chicken”
California workers’ comp technically offers an appeals process for providers to dispute incorrect reimbursements. However, this appeals process actually encourages claims adm...
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...
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...