Utilization Review

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...

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...

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...

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...

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...

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...

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.

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 (...

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...

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...

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...

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...