UR
Sep 4, 2024
The $10,000 Lie California Tells Injured Workers
Lie: California workers receive immediate and continued treatment (up to $10,000) when they file a work injury claim.Fact: California allows claims administrato...
Aug 21, 2024
CCCSIG Adds Bogus "Expiration Date" to UR Approval
Let’s be absolutely clear: in California workers’ comp, treatment authorization does not expire. Once Utilization Review (UR) determines that treatment is authorized, there i...
Aug 8, 2024
daisyData: CA RFA & Utilization Review 2024 Data
In California, Utilization Review (UR) is the mandatory process by which claims administrators decide whether or not to approve treatment requests submitted by doctors treati...
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Aug 5, 2024
EK Health: Denying Care Helps Injured Workers
EK Health wants you to know that Utilization Review (UR) is not a soulless tool that payers use to deny injured workers the care recommended by their treating physicians....
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Jul 24, 2024
CA DWC to Impose Costly New Reporting Burdens on Providers
California’s Division of Workers’ Compensation (DWC) is proposing major changes to the forms providers use for injured workers’ Progress Reports, the Doctors’ First Report of...
May 16, 2024
CA DWC Website Deletions Enrich Claims Administrators
Given the complexity of workers’ comp (and the myriad ways claims administrators improperly deny requests for treatment and payment), knowledge is a precious resource for pro...
May 9, 2024
CA DWC Deletes Med-Legal FAQ From Website
California’s Division of Workers’ Compensation (DWC) is supposed to have a critical role in enforcing state laws and regulations. Just as critically, the DWC has a duty to
Apr 2, 2024
CA UR: AmTrust & Genex Deny Care With ODG (Again)
What suffering must befall injured workers before California bothers to enforce its meager Utilization Review (UR) requirements?When considering which treatments are n...
Feb 9, 2024
Will CA Clean Up Authorization/UR Issues?
When it comes to payer abuse of the authorization process in healthcare, the jig isn’t exactly up yet — but federal legislators and regulators seem to be catching on to priva...
Feb 8, 2024
CA Authorization & UR Confusion Reigns
Last week, we reported on the California Division of Workers’ Compensation (DWC)’s decision to delete an important FAQ from its website. Until the deletion, the FAQ affirmed ...
Jan 18, 2024
Obituary: Palomar Urgent Care (for Injured Workers)
California workers’ comp has lost yet another sizable medical practice, in another unmistakable sign of the ongoing breakdown of the system.Palomar Health Medical Grou...
Jan 9, 2024
Albertsons Employee's Post-Amputation UR Nightmare
Two days before Christmas in 2022, an Albertsons Companies employee suffered “traumatic amputations” of three toes in a work accident. This worker lived alone on the t...