Third-party Administrator

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) ...

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 ...

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...

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...

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...

MGM Resorts Claims Administrator Guide

Billing for the treatment of injured MGM Resorts employees can get complicated. That’s because MGM uses a combination of insurance companies and Third-Party Administrators (T...

Employers Beware: LWP Is a Bad Look

Most California self-insured employers utilize a Third-Party Administrator (TPA) to handle injured workers’ claims on their behalf. But not all TPAs are equally competent in ...

City of LA Claims Administrator Guide

The City of Los Angeles is a public-sector self-insured employer. As such, billing for the treatment of its injured workers can be complicated. For injured worker claims, the...

CA TPA Resolves e-EOR Data Errors

When it comes to California workers’ comp payment requirements, there is no such thing as half-compliance.Recently daisyBill reached out to a major Third-Party Adminis...

City of Oxnard Changes TPA

Third-Party Administrator (TPA) Acclamation Insurance Management Services (AIMS) is having a rough summer, as various self-insured employers switch from AIMS, choosing instea...

City of Hayward Changes TPA

Self-insured employers in California are apparently reconsidering their use of Third-Party Administrator (TPA) Acclamation Insurance Management Services (AIMS). Several emplo...

CA Judicial Branch Changes TPA

Third-Party Administrator (TPA) Acclamation Insurance Management Services (AIMS) has lost another employer client. As of July 1, 2022, the California Judicial Branch Workers’...