sedgwick
Apr 27, 2023
Sedgwick Racks Up 79,318 DWC Audit Complaints
Third-Party Administrator (TPA) Sedgwick Claims Management Services, Inc. continues to ignore California workers’ comp billing regulations with impunity.Currently, Sed...
Apr 18, 2023
Sedgwick: Sham MPN Impedes Care?
If you need proof that California’s Medical Provider Network (MPN) system is catastrophically flawed, look no further than the case of the injured worker below.Third-P...
Apr 6, 2023
Sedgwick, Please Accept a Free Gift From daisyBill
Sedgwick Claims Management Services, daisyBill is here for you.We notice that you struggle mightily with correctly calculating reimbursements under California’s...
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Mar 23, 2023
ACE / Sedgwick Low Payments Reveal PPO Problem
If you’ve ever wondered why so many California doctors avoid treating injured workers, stop wondering. Three separate bills from the same provider to the same insurer...
Mar 20, 2023
Mirage Provider Networks: Sedgwick Can't Identify MPN
At this point, Medical Provider Networks (MPNs) can feel like little more than a cruel joke, offering seemingly ephemeral benefits to providers while exacting a heavy toll in...
Jan 30, 2023
Med-Legal IBR Data: A Bad Look for Sedgwick & CA
California appears to turn a willfully blind eye to what seems like an abuse of the Independent Bill Review (IBR) system for Medical-Legal disputes.Data ...
Jan 11, 2023
Sedgwick Authorization Sewer - Why CA Needs UR Reform
An injury occurs at work. The injured worker sees a doctor. The doctor concludes that the worker needs a consultation from a specialist. Per California law, the treating doct...
Dec 14, 2022
Sedgwick's 57,876 Audit Complaints: A Business Practice?
Sedgwick received our open letter, but the Third-Party Administrator (TPA) still missed the memo. Sedgwick administers claims on behalf of insurers and self-insured em...
Dec 14, 2022
Sedgwick Missing e-EORs: 31,906 Audit Complaints Submitted
Sedgwick Claims Management Services is breaking the law. We encourage the California Division of Workers’ Compensation (DWC) to assert its role in upholding workers’ comp law...
Dec 1, 2022
MPN Chaos: Trader Joe's Employee Denied QME Treatment
Third-Party Administrator (TPA) Sedgwick Claims Management Services, acting on behalf of ACE American Insurance Company, refused to consider authorizing care recommend...
Dec 1, 2022
Sedgwick Uses Terminated ACE American MPN to Deny Payment
The Medical Provider Network (MPN) system in California is so chaotic, even the adjusters can’t keep up.For example: Third-Party Administrator (TPA) Sedgwick Claims Ma...
Dec 1, 2022
MPN Chaos: Sedgwick Denies QME Payment - Lowe's Home Center
The Medical Provider Network (MPN) system in California is out of whack — to the point that it breeds the kind of improper payment denials that make it impossible not to ask ...