sedgwick
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...
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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...
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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...
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...
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 ...
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...
Mar 12, 2024
daisyBill Takes Sedgwick Complaints to CA DWC Administrative Director
It may be a new year, but it’s the same ol’ Sedgwick. However, the California Division of Workers’ Compensation (DWC) has indicated it may take a different (and hopefu...
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Mar 6, 2024
e-Billing: Unstoppable Delivery of Workers' Comp Bills
The days of hoping a workers’ comp e-bill will make it to the payer are over. Too often, providers receive notification that their e-bills were rejected by the payer o...
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Jan 29, 2024
Sedgwick: 49% of Appeals Incorrectly Denied
Sedgwick Claims Management Services, Inc. is notorious for failing to respond compliantly to California providers’ bills for treating injured workers. But the Third-Party Adm...
Jan 24, 2024
Sedgwick Is Only Getting Worse
When regulators allow payers to disregard workers’ compensation laws and regulations with impunity, providers cannot help but view the system as rigged against ...
Dec 19, 2023
Sedgwick Racks Up Another 11,947 Audit Complaints
Since October 2012, California law has required workers’ comp claims administrators to accept electronic bills (e-bills) from providers, and to respond to those e-bills with ...
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...