Third-party Administrator

Sedgwick Reverses Teacher’s Injury Denial Following Media Coverage

An apocryphal quote attributed to Winston Churchill holds that Americans will always do the right thing, but only after they’ve tried everything else.Churchill probabl...

TX: “War on Sedgwick” as First Responders Report Delays

According to the Fort Worth Star-Telegram, almost a quarter of workers’ comp claims filed by Fort Worth first responders between January 2024 and March 2026 were denied by Th...

Sedgwick Continues to Fail FedEx (and CA Providers)

FedEx is a massive American company with over half a million employees. The shipping giant has chosen to entrust Sedgwick Claims Management Services, Inc...

Sedgwick’s Sloppy Handling of Starbucks Claims

Is Sedgwick Claims Management Services, Inc. even trying?The Third-Party Administrator (TPA) is the largest in workers’ comp, managing claims for a massive portfolio o...

daisyData: The 5 Worst Workers’ Comp TPAs

As we discussed in our look at the top-performing Third-Party Administrators (TPAs), TPAs are a critical component of workers' comp systems in most states. When a TPA upholds...

daisyData: Top 5 TPAs Helping Workers’ Comp Work Better

Across the nation, many doctors avoid taking on workers’ comp patients for one simple reason: obtaining payment can be a nightmare. Electronic billing (e-billing) has ...

ESIS and Its Unreachable Adjuster Fail to Respond to e-Bills

Third-Party Administrator (TPA) ESIS completely failed to respond to multiple electronic bills (e-bills) for an injured Allied Universal employee’s treatment by the legally m...

CCMSI e-EOR Violations Create Chaos for Providers

In California and other states, payers must respond to providers' electronic bills (e-bills) with electronic Explanations of Review (e-EORs), which automatically post payment...

Alert: Providers, Opt Out of CCMSI Virtual Credit Card Payments Now

Third-Party Administrator (TPA) Cannon Cochran Management Services, Inc. (CCMSI) has partnered with MedRisk and ECHO Health, Inc. to foist Virtual Credit Card (VCC) payments ...

Gallagher Bassett Denies Payment for Non-Authorization (Despite Proof of Authorization)

California has a workers' compensation system in which payers can't lose.In practice, there are no penalties for refusing to pay a legitimate bill; no consequences for...

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...