sedgwick
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...
Jan 17, 2020
Sedgwick – IBR Hall of Shame
All too often, insurance companies and claims administrators find unfair ways to deny, delay, and otherwise wiggle out of paying the workers’ compensation reimbursements that...
Sep 20, 2019
Huntington Hospital & City of Beverly Hills Change TPAs
Attention providers: two California employers switched third-party administrators (TPAs).Huntington Hospital transferred claims from Sedgwick to AthensCity of B...
Sep 19, 2019
York (aka Sedgwick) Fails Math: EORs Literally Don't Add Up
York Risk Services, which was acquired this month by Sedgwick, has significant math troubles. York recently returned Explanations of Review (EORs) which obfuscated the effect...
Aug 5, 2019
Blatant Disregard for IBR Law by Sedgwick, Gallagher, Athens, Helmsman
A disturbing pattern is emerging from the results of Independent Bill Review (IBR) decisions in the state of California. As usual, the problem encumbers workers’ comp provide...
Jul 2, 2019
Claims Admins Deny Second Review Appeals as Duplicate Bills
Two claims administrators, York and Sedgwick, denied hundreds of compliant second review appeals on the grounds that the appeals were “duplicates” of the Original Bills in qu...