sedgwick

Sedgwick Authorization Sewer - Why CA Needs UR Reform
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...
Sedgwick's 57,876 Audit Complaints: A Business Practice?
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...
Sedgwick Missing e-EORs: 31,906 Audit Complaints Submitted
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...
MPN Chaos: Trader Joe's Employee Denied QME Treatment
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...
Sedgwick Uses Terminated ACE American MPN to Deny Payment
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...
MPN Chaos: Sedgwick Denies QME Payment - Lowe's Home Center
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 ...
CA: Sedgwick Stiffs Doctor Who Treated Injured Honda Worker
Nov 29, 2022
CA: Sedgwick Stiffs Doctor Who Treated Injured Honda Worker
The Medical Provider Network (MPN) system in California is chaos — and chaos breeds the kind of abuse that is currently crippling workers’ comp.Case in p...
Sedgwick Stiffs QME With False MPN Denial (Again)
Nov 2, 2022
Sedgwick Stiffs QME With False MPN Denial (Again)
It’s been said that insanity is best defined by doing the same thing repeatedly, but expecting different results. If that’s the case, Sedgwick Claims Management Services has ...
An Open Letter to Sedgwick Claims Management Services, Inc.
Sep 26, 2022
An Open Letter to Sedgwick Claims Management Services, Inc.
Dear Sedgwick Claims Management Services,This is a plea. In all sincerity, and all snark aside, California workers, providers, and employers need you to do bett...
Sedgwick Asserts CA "Loosened" Appeal Process
Jun 28, 2022
Sedgwick Asserts CA "Loosened" Appeal Process
California workers' comp is — supposedly — governed by laws, enacted by the state legislature, and carried out by the Division of Workers’ Compensation (DWC). For disputes ov...
Data: Sedgwick Fails to Process 16,261 Second Review Appeals
Jun 28, 2022
Data: Sedgwick Fails to Process 16,261 Second Review Appeals
Third-Party Administrator (TPA) Sedgwick Claims Management Services consistently ignores California workers’ comp requirements for properly responding to Second Review appeal...
Audit Complaint: Sedgwick 16,261 Noncompliant Second Review Responses
Jun 28, 2022
Audit Complaint: Sedgwick 16,261 Noncompliant Second Review Responses
Using data generated by tens of thousands of electronic bills sent by our provider clients, daisyBill has demonstrated consistent non-compliance with California e-billing reg...