Third-party Administrator

📬 Payer Responses: Guile, Waiting, and Crickets 🏏

Today we report on the responses from Sedgwick, Liberty Mutual, York, and State Compensation Insurance Fund (SCIF), following our posts detailing their systematic underpaymen...

SCIF (CA) Incorrectly Paying 2018 Fee Schedule for 2019 DOS

It’s SCIF’s turn. The California State Compensation Insurance Fund (SCIF) is also incorrectly reimbursing providers using the 2018 Physician Fee Schedule instead of the corre...

The Payment Chaos Continues: Sedgwick Denies Appeal for Correct 2019 Reimbursements

Sedgwick’s payment mistakes multiply. First, Sedgwick incorrectly paid California providers by applying an old workers’ comp fee schedule. Now Sedgwick compounds its error by...

York Misses the Mark: Paying 2019 Bills at 2018 OMFS Rates

Not one to avoid the spotlight, York Risk Services joins Sedgwick CMS in incorrectly applying the 2018 Physician Fee Schedule rates to services rendered in 2019. Our data sho...

State Farm Workers’ Comp Claims Moved to Sedgwick CMS

Time to start counting your poultry -- State Farm’s workers’ compensation henhouse is now guarded by the third-party administrator (TPA) Sedgwick, effective October 21, 2018....

Sedgwick Still Reimbursing at 2018 Rates for California

Since the beginning of 2019, Sedgwick CMS has incorrectly used the 2018 Physician Fee Schedule to reimburse providers. Our data indicates that Sedgwick is consistently and in...

York Risk Services Must Treat CA Providers Better

DaisyBill strives to make workers’ comp billing and payment smoother for both providers and payors. We work with thousands of payors, including employers, insurers, an...

Bill Review: What It Is, and Why It’s Hurting Workers’ Compensation

Bill review is very profitable. Sadly, that profit comes at the expense of other stakeholders in workers’ comp. Bill review is a huge part of the workers’ comp billing...