sedgwick

Sedgwick (and the DWC) Ignore Providers' Appeals
Jun 12, 2024
Sedgwick (and the DWC) Ignore Providers' Appeals
Sedgwick is running roughshod over California providers, in violation of state workers’ comp law. By failing to take substantive action, the Division of Workers’ Compe...
Sedgwick Denies/Ignores Hundreds of Appeals
Jun 10, 2024
Sedgwick Denies/Ignores Hundreds of Appeals
Sedgwick's persistent failure to pay providers in accordance with state workers' comp fee schedules and its refusal to respond compliantly to providers’ appeals are glaring v...
Sedgwick Stiffs Doctors With Outdated Fee Schedule Rates
May 13, 2024
Sedgwick Stiffs Doctors With Outdated Fee Schedule Rates
The California Division of Workers’ Compensation (DWC) increased reimbursements for physician services for dates of service on or after April 1, 2024. Yet Third-Party Adminis...
daisyBill Sends 13K+ Sedgwick Violations to CA DWC Director
May 10, 2024
daisyBill Sends 13K+ Sedgwick Violations to CA DWC Director
Sedgwick’s consistent refusal to comply with California workers’ comp laws and regulations shows no signs of abating—in fact, it’s getting worse.Having been instructed...
Sedgwick Fails to Pay IBR Filing Fee for Zillionth Time
May 3, 2024
Sedgwick Fails to Pay IBR Filing Fee for Zillionth Time
Once more for the cheap seats: when Independent Bill Review (IBR) determines that a claims administrator erroneously denied or adjusted the reimbursement owed to a provider, ...
Orange County/Sedgwick Inflict MPN Mayhem
May 2, 2024
Orange County/Sedgwick Inflict MPN Mayhem
How much of California workers’ comp dysfunction directly results from the effectively ungoverned Medical Provider Network (MPN) system? California does not furnish an...
Orange County/Sedgwick: Preposterous MPN Telehealth Claim
May 1, 2024
Orange County/Sedgwick: Preposterous MPN Telehealth Claim
What in the name of comp are the County of Orange and Third-Party Administrator (TPA) Sedgwick up to? As reported previously, Sedgwick insists Orange County will refus...
Despite Orange County/Sedgwick Whims, Telehealth Is Payable
Apr 30, 2024
Despite Orange County/Sedgwick Whims, Telehealth Is Payable
In this second look at the County of Orange’s refusal to pay for telehealth treatment, we pose a critical question: What kinds of chaos will be unleashed if Orange Cou...
Orange County & Sedgwick "No Telehealth" Policy
Apr 29, 2024
Orange County & Sedgwick "No Telehealth" Policy
According to Third-Party Administrator (TPA) Sedgwick, the County of Orange refuses to reimburse providers for treating injured employees via telehealth.Sedgwick claim...
Sedgwick: IBR Filing Fee Hall of Shame (Again!)
Apr 25, 2024
Sedgwick: IBR Filing Fee Hall of Shame (Again!)
Another day, another IBR fee run-around. California law is clear: when Independent Bill Review (IBR) overturns a claims administrator’s incorrect adjudication of a provider’s...
Sedgwick: IBR Filing Fee Hall of Shame
Apr 19, 2024
Sedgwick: IBR Filing Fee Hall of Shame
The good news: When Independent Bill Review (IBR) overturns an improper payment denial, Sedgwick Claims Management, Inc. will restore the $180 filing fee the provider ...
C'mon, Sedgwick: TPA Tries PPO Discount for Med-Legal (Again)
Apr 18, 2024
C'mon, Sedgwick: TPA Tries PPO Discount for Med-Legal (Again)
We’ll say it as often as we have to: Preferred Provider Organization (PPO) discounts do not apply to bills for Medical-Legal services. It’s a lesson that Sedgwick Clai...