Second Review

The Hartford Doubles Down on Improper Payment Denials (Part 2)

California consistently fails to uphold one of the most important legal principles of its workers’ comp system: treatment authorization assures payment to the healthcare prov...

The Hartford Doubles Down on Improper Payment Denials (Part 1)

California law requires insurers to honor authorization for medically necessary treatment as a legally binding, non-rescindable guarantee of reimbursement. The Hartford is ei...

CA: Sedgwick's Flagrant Second Review Violations Continue

Third-Party Administrator (TPA) Sedgwick Claims Management Services, Inc. continues to deny California providers’ Second Review appeals at high rates for an incorrect, laugha...

accūrō Solutions: Proactive Bill Review Improves Compliance for Payers

It’s not all bad news in the world of workers’ comp billing. While daisyNews regularly holds payers and their vendors accountable for their failures, some companies de...

CA Providers Recovered $22M in 2025

Improper denials and payment adjustments are inevitable for California providers who treat injured workers. But in 2025, California providers recovered over $22 million using...

How Much Revenue Are You Losing from Workers’ Comp Billing & Payment Errors?

Improper denials and payment adjustments are inevitable for California providers who treat injured workers. If you don’t address them, the costs add up quickly.In 2025...

How daisyBill Automates Workers’ Comp Fee Schedule Enforcement and Second Review Appeals

Workers’ compensation underpayments are not outliers. They are systematic, predictable, and too often unchallenged.For medical providers, the problem is not identifyin...

CA: Sedgwick’s Rampant Second Review Violations

For providers, Sedgwick Claims Management Services, Inc.’s routine violations of state law and regulations make it increasingly difficult to treat injured workers. For...

Helmsman Makes Ransom Demand for Refund Request (Part 3)

Helmsman Management Services, LLC, a Third-Party Administrator (TPA), has refused to process a Second Review appeal submitted by a California physician who treated an ...

Sedgwick’s Abuse of Providers Should Terrify Employers

A question for California employers: If Sedgwick Claims Management Services, Inc. (Sedgwick) treats doctors as poorly as our data reveal, what is the impact on your injured e...

$18 Million Battle: How California’s Rigged Workers’ Comp System Cheats Providers

The 2024 data are in, and they paint a grim picture for every California provider treating injured workers. The numbers prove beyond a doubt that California’s workers’...

Audit Complaint: Sedgwick - 5,415 Violations Reported

Once again, daisyBill has filed a formal Audit Complaint with the California Division of Workers’ Compensation (CA DWC) against Sedgwick Claims Management, Inc.The Thi...