Utilization Review
Sep 11, 2023
UR: An Open Letter to CA Residents
Dear California Readers,One of your neighbors experienced a significant head injury while repairing California highways. This individual has diminished cognitive abili...
Sep 6, 2023
SCIF: Inept Utilization Review Delays Care for Injured Worker
We write often about the systemic issues surrounding Utilization Review (UR) in California and the constant struggle of providers to obtain authorization to tre...
Aug 22, 2023
Provider UR Data Belies Rosy Insurer Claims
At a recent California Division of Workers’ Compensation (DWC) meeting, a representative from the California Workers’ Compensation Institute (CWCI) — an insurers’ organizatio...
Aug 15, 2023
RFA: UR Decision Data 2023
On Friday, a California Workers’ Compensation Institute (CWCI) representative reportedly cited a 95% approval rate for medical treatments requested by California providers. T...
Jul 11, 2023
California DWC - Division of Wretched Compensation
Immediately after an employee reports a work-related injury, the employer’s claims administrator is allotted up to 90 days to accept or reject liability for the reported inju...
Jun 20, 2023
Medical Director: CA Workers' Comp "Subsidizes Corruption"
Recently, the Medical Director of a large medical group sent an email to daisyBill, explaining their decision to "opt out" of treating injured workers in California. T...
Jun 7, 2023
5 Ways the RFA System Burdens Providers
In California, injured workers’ access to care depends directly on how physicians manage the state’s onerous authorization and Utilization Review (UR) requirements.
Jun 6, 2023
Missing UR Decisions (and Other RFA Problems) Solved
If your practice treats injured workers, you can’t get reimbursed without proof of authorization. Fortunately, California makes submitting Requests for Authorization (...
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...
May 9, 2023
RFA: How Technology Can Document UR Decisions
For providers, workers’ comp’s biggest challenges are obtaining authorization for treatment, and getting paid for providing the authorized treatment. Both chall...
Apr 26, 2023
Video: 30-Second RFAs for CA Workers' Comp
Let’s face facts: treating injured workers is a massive administrative pain for California providers and their staff. And that pain starts with the mandated employer authoriz...
Feb 15, 2023
Data: CA UR Decisions 2022
One of the great sources of friction in California workers’ comp is the Utilization Review (UR) and treatment authorization process — the critical process that determines whe...