sedgwick
Jun 15, 2022
Sedgwick: Gruesome and Abusive IBR Games
In California workers’ comp, providers cannot rely on authorization to guarantee payment — despite what the law says. Today’s article shows exactly how a claims administrator...
May 18, 2022
Sedgwick Resolves LA County Missing e-EORs
daisyBill contacted Sedgwick regarding e-bills for treatment rendered to employees of the County of Los Angeles (claims beginning with 5000 or ending in D), for...
Mar 2, 2022
Sedgwick EDI Alert: Correct Payer ID WX867
daisyBill is aware of confusion regarding the correct Payer ID providers should use when submitting e-bills to Sedgwick, a third-party administrator (TPA).<...
Sep 21, 2021
Dollar Tree/Sedgwick Won’t Pay for Authorized Treatment
Authorization is, by definition, a promise.It’s the promise that, once a doctor obtains authorization from an employer to treat an injured worker, the employer will pa...
Aug 11, 2021
Sedgwick: Sketchy EOR Math for LA Unified School District
Sedgwick recently returned an Explanation of Review (EOR) that failed to fulfill a crucial requirement: showing how Sedgwick actually calculated the reimbursement amount paid...
Jul 15, 2021
Sedgwick Violates LACoFD Employer Contract, IBR Drops Ball
A physician agreed to serve as Independent Medical Examiner (IME) for the Labor Management Committee (LMC) representing the Los Angeles County Fire Department (LACoFD) and Lo...
Jul 12, 2021
Sedgwick Denies Second Review Appeals as "Duplicates"
Sedgwick has a Second Review problem.On too many occasions, Sedgwick incorrectly denies providers’ Second Review appeals as “duplicate submissions” of the original bil...
Jul 6, 2021
IBR Hall of Shame: Sedgwick Sets New Standard of Noncompliance
Sedgwick failed to comply with an Independent Bill Review (IBR) ruling for almost four months. Worse, the payor’s brazenness is likely to go unpenalized by the state.T...
Feb 22, 2021
Sedgwick & Mitchell Setting Up a Legal Protection Racket?
Sedgwick, in cahoots with Mitchell, seems to be setting up some kind of protection racket where, in exchange for providers accepting lower reimbursement, Sedgwick/Mitchell wi...
Sep 18, 2020
Sedgwick Fails the University of California
Today we are focusing on a self-insured employer, the University of California, and its third-party administrator, Sedgwick. Unfortunately, Sedgwick is not complying with Cal...
Sep 8, 2020
Clearinghouse Error - WorkCompEDI Misdirects Bills
Recently, one of the six clearinghouses hired by claims administrators to accept electronic workers’ comp bills suffered a technical error which resulted in the clearinghouse...
Feb 13, 2020
Sedgwick Erroneously Rejects Provider Bills
Workers’ comp providers, be aware: insurer Sedgwick has recently incorrectly rejected multiple bills on erroneous grounds, necessitating that time and resources be spent inve...