sedgwick

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...
daisyBill Takes Sedgwick Complaints to CA DWC Administrative Director
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...
e-Billing: Unstoppable Delivery of Workers' Comp Bills
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...
Sedgwick: 49% of Appeals Incorrectly Denied
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...