Is the MPN Simplifying Workers’ Compensation or Complicating It?
In California’s workers’ compensation system, navigating the (MPN) is crucial yet challenging. Medical providers usually have to take the fall in these MPN personas. When an injured factory worker with a severe back injury needs care outside the MPN due to the absence of necessary specialists, instead of catering to the needs of the case, […]
Legal Basis Denial Dilemma
In worker’s compensation cases, providers often encounter obstacles in the billing and collection process. Insurance companies may decline coverage due to certain legal aspects, citing reasons such as post-term claim or statute for filing an injury. This situation can lead to patients grappling with substantial medical costs while providers have outstanding claims paid. A longtime […]
Using the RFA System to Our Client’s Benefit
In workers comp cases, the UR process can be confusing and slow, making it difficult for providers to get their dues cleared on time. Let’s delve into how we secured our client’s payment in this case through careful abidance to RFA guidelines. A warehouse worker sustains a wrist injury while operating heavy machinery at her […]
Simplify Lien Collection for Retrospective Denial of Treatment
In worker’s compensation claims, denials, and deferrals by administrators can hinder the collections of the medical providers and lead to legal disputes. When there’s a debate about which part of the body was injured at work, the request for treatment might be denied or deferred retroactively. In such cases, if the provider undertook the treatments, […]
Navigating UR Deferral Issues
In the world of workers’ compensation, navigating the complexities of Utilization Review (UR) deferral issues can be a real headache. But fear not, because Medical Lien Management has a solution to it and can help out in it. Let’s dive into a recent case that sheds light on how to handle such scenarios like a […]
Denial on the Legal Basis
David, construction worker, who suffered a serious injury on the job due to faulty equipment. Despite clear evidence of negligence on the part of his employer, David’s workers’ compensation claim was denied based on a legal technicality – the statute of limitations for filing a claim had expired. Determined to fight for justice, David enlisted […]
Denial on the Medical Basis
Today, let’s embark on an adventure through the world of denials, using real-life cases to shed light on how to navigate these tricky situations. Buckle up, because we’re about to dive deep into the stories of individuals who faced denials head-on and emerged victorious! Sarah, hardworking nurse, who injured her back while lifting a patient […]
