sedgwick
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...
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Nov 8, 2023
Sedgwick's UR Obstacle Course Delays Care
Welcome to California workers’ comp, where the law requires two doctors to do the job of one:A treating physician to heal the injured worker A Utilization Revie...
Oct 18, 2023
Sedgwick: 13,248 Audit Complaints Filed With CA DWC
In keeping with years of consistent violations of California laws and regulations, Sedgwick Claims Management Services continues to fail to send mandatory electronic Explanat...
Aug 31, 2023
Provider Alert: Sedgwick Can't Pay Bed Bath & Beyond Bills
FYI, providers: if your practice treats injured employees of the newly bankrupt Bed Bath & Beyond, you may have trouble getting paid.A daisyCollect provider recently b...