Third-party Administrator

Billing Alert: CA State Fund Drops TPA

Attention California providers: Third-Party Administrator (TPA) Acclamation Insurance Management Services (AIMS) is no longer handling workers’ comp claims for employees of t...

Adminsure Billing Nightmare: Public Pays the Price for Friction (Part 2)

In Part 1 of our exposé on Adminsure, we detailed the painful odyssey providers must endure just to confirm payment for the treatment of injured workers.Below, we spot...

Adminsure Makes Billing a Nightmare for Providers (Part 1)

Adminsure is a prime example of why providers hesitate to treat injured workers.In multiple cases, Adminsure compliantly sent an electronic Explan...

CorVel’s Commitment to Compliance: A Shining Example for Payers

CorVel, a Third-Party Administrator (TPA) managing workers’ comp claims on behalf of insurers and employers, has demonstrated how workers’ comp works better when payer...

Sedgwick (Still!) Owes CA Practice $500k+ After Bogus PPO Discounts

Sedgwick Claims Management Services,Inc. has withheld hundreds of thousands of dollars in reimbursement from a single California orthopedic practi...

Labor: “Predatory” Sedgwick Is “a Menace to Workers”

Labor representatives are finally saying it out loud: Sedgwick Claims Management Services, Inc. is a “menace” to injured workers.Transport Workers Union (TWU) Local 100 isn’t...

IBR Chicken: ESIS Denies Common CPT Codes as "Invalid"

Third-Party Administrator (TPA) ESIS’s apparent lack of basic knowledge about California workers’ comp billing should concern insurers like Safety National Casualty Corporati...

Starbucks, Are You Paying Attention? Sedgwick’s Numbers Don’t Match

California employers should be suspicious of Third-Party Administrator (TPA) Sedgwick’s record-keeping.A doctor (a daisyCollect client) treated a Starbucks injured wor...

Sedgwick’s Shell Game? 139 CA Employers Exposed

A California workers’ comp physician recently received eight checks totaling $110,858 from Careworks, a vendor affiliated with Third-Party Administrator (TPA) Sedgwick.

NY Provider Alert: Sedgwick Creates Chaos for MTA Claims

A heads-up to New York providers treating Metropolitan Transportation Authority (MTA) employees: Sedgwick Claims Management Services, Inc. is reportedly creatin...

Helmsman Makes Ransom Demand for Refund Request (Part 3)

Helmsman Management Services, LLC, a Third-Party Administrator (TPA), has refused to process a Second Review appeal submitted by a California physician who treated an ...

Diabolical Discounts: Ralphs Pays MD $44 to Treat Injured Worker

Our weekly “Diabolical Discounts” features the most atrocious examples of the low reimbursements doctors receive for treating California’s injured workers.<...