UR
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...
Jan 8, 2024
daisyNews: 2023 Top 10 Articles
In 2023, daisyNews tackled the stories, trends, and issues that had the biggest impact on providers who treat injured workers. Below, we share the 10 most-read articles of th...
Dec 15, 2023
UR Data Supports CA Legislators' Fears
As early as 2016, California legislators were aware of potential abuse of the Utilization Review (UR) process. These legislators attempted to address the problem by en...
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Dec 12, 2023
CA: Will DWC Publish Physician UR Denial Data in 2024?
January 1, 2024 is approaching. Will the California Division of Workers’ Compensation (DWC) comply with state law requiring the DWC to publish physician utilization (U...
Dec 5, 2023
CA DWC: Continued Failure of Regulatory Oversight
California has laws and regulations requiring claims administrators to timely and compliantly conduct Utilization Review (UR) of every treatment recommended by an injured wor...
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Dec 4, 2023
Attn CA DWC: Where Is the UR Reporting System?
In 2014, California legislators enacted laws requiring employers to conduct Utilization Review (UR) for every treatment recommended for a work-related injury. I...
Nov 9, 2023
Gallagher Bassett Flips UR Decision, Confusion Reigns
To an injured worker denied the care their treating physician deems necessary, California’s Utilization Review (UR) process can seem arbitrary, even cruel. This percep...
May 22, 2023
RFA: The Easy Way to Manage UR Decisions
So many injuries. So many Requests for Authorization (RFAs). So many Utilization Review (UR) decisions to keep track of — and only so much time in a day.Rest easy, pro...