Frequently Asked Questions
Speciality Risk Services Acquired by Sedgwick
According to multiple news sources, in 2011 Sedgwick CMS acquired Speciality Risk Services (SRS) from The Hartford Financial Services Group.
Everest National Insurance
DaisyBill lists Everest National Insurance (Everest) as an invalid claims administrator.
DaisyBill lists Arch Insurance Group as an invalid.
An investigation by NBC’s California Bay Area affiliate reports that San Jose’s Human Resources Department has overturned Athens Administrators’ denial of treatment to dozens of San Jose firefighters.
State Compensation Insurance Fund
Per a representative, State Compensation Insurance Fund (SCIF) unveiled a “new program” with regard to billed Evaluation and Management codes (CPT codes 99201 – 99205 for new patients; 99211 – 99215 for returning patients). If the level of billed E/M service is not supported by the supporting documentation, the E/M code will now be denied and $0 will be sent as payment.
AIG / MedRisk Incorrect Denials
DaisyBIll providers report receiving incorrect and very confusing denials from MedRisk, a managed care provider network, for bills that were actually submitted directly to AIG. The MedRisk denials state: “Not currently a participating MedRisk provider. Please submit bill directly to insurance carrier.”
City of LA Switches Bill Review to Medata
The City of Los Angeles recently shook up their Bill Review program, making the switch from Stratacare to Medata as of April 1, 2017.
County of Ventura Switches Bill Review to York
The County of Ventura severed its alliance with CorVel, opting instead to partner with York as of May 1, 2017. The DaisyBill compliance team reached out to York, CorVel, and the County of Ventura for details. All three entities confirmed the change. We also learned something else: York will be changing the claim numbers for all County of Ventura bills with dates of service prior to May 1, 2017.
American Airlines Switches Bill Review
Self-insured employer American Airlines no longer utilizes Genex Services Bill Review. Effective February 1, 2018, American switched to Sedgwick National Bill Review.
JCPenney Switches TPA; Claims Assigned New Claim Numbers
JCPenney no longer utilizes third-party claims administrator Sedgwick Claims Management Services. The retail department store chain transferred all claims to AIG Claims, Inc., effective February 2, 2018.
Macy's, Sedgwick Bill Review, and Payor ID
Self-insured employer Macy’s no longer utilizes EK Health Bill Review. Effective March 3, 2018, Macy’s switched to Sedgwick Claims Management Services National Bill Review.
DaisyBill is a trusted authority on workers’ comp billing. Thousands of work comp professionals attend our webinars and state agencies and professional organizations turn to us for our expertise. We created this blog to help everyone involved in workers’ compensation; sharing news, tips, and data of interest to the community.
Drop us a line with any news you would like us to share or any issue that concerns you.