TPA

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...

CA DWC Fails, Vendors Thrive, Employers Pay More

Fact: In California workers’ comp, the claims administrator is legally responsible for compliance with state laws and regulations, regardless of any outside vendor or agent t...

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...

Accelerated Claims Breaks CA Law, Only Accepts Bills by Mail

A Third-Party Administrator (TPA) has one relatively straightforward job: to handle injured workers’ claims on behalf of an employer or insurer.Accelerated Claims Serv...

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...

Sedgwick’s Dismal EDI Grade Disaster

Third-Party Administrator (TPA) Sedgwick Claims Management Services, Inc. has earned a solid “D” for its Electronic Data Interchange (EDI) performance, a dismal grade that si...

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.