Third-party Administrator
Jul 22, 2025
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...
May 27, 2025
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 ...
May 16, 2025
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.<...
May 12, 2025
Sedgwick Stiffs Doctors, County of LA Taxpayers Pick Up the Tab
Sedgwick Claims Management Services, Inc. has made it a business practice to defy California workers’ compensation laws, and public entities like the County of ...
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May 8, 2025
Helmsman Botches NBC Injury Claim—Underpays Doctor, Demands Refund Anyway (Part 2)
As daisyNews reported yesterday, Helmsman Management Services, LLC attempted to claw back payment from a California provider for plainly bogus reasons. We debunked those reas...
May 7, 2025
Helmsman's Ridiculous Refund Request (Part 1)
Why do so many doctors avoid treating injured workers? We have a perfect illustration from Helmsman Management Services LLC. This Third-Party Administrator (TPA) recently:
Nov 11, 2024
CA: USC Switches Workers' Comp TPA
The University of Southern California (USC), a self-insured employer, has switched the Third-Party Administrator (TPA) it uses to handle workers’ comp claims for its injured ...
Oct 29, 2024
CA Alert: ESIS e-Bill Rejections (and What to Do)
Third-party administrator (TPA) ESIS is improperly rejecting valid e-bills from California providers, citing an inexplicable, seemingly random (and definitely non-compliant) ...
Jul 9, 2024
Sedgwick <> Data Dimensions - Married or Divorced?
Sedgwick Claims Management Services, a Third-Party Administrator (TPA), and Data Dimensions, a clearinghouse vendor, may have gotten hitched.Imagine our surprise when ...
Apr 18, 2024
C'mon, Sedgwick: TPA Tries PPO Discount for Med-Legal (Again)
We’ll say it as often as we have to: Preferred Provider Organization (PPO) discounts do not apply to bills for Medical-Legal services. It’s a lesson that Sedgwick Clai...
Mar 12, 2024
daisyBill Takes Sedgwick Complaints to CA DWC Administrative Director
It may be a new year, but it’s the same ol’ Sedgwick. However, the California Division of Workers’ Compensation (DWC) has indicated it may take a different (and hopefu...
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...