Send us a text Ep. 315 – Preparing for Billing Audits: Ensuring Compliance in 2025 Billing audits are tightening in 2025, and even small mistakes can lead to big penalties. Anique and Angela break down the new audit standards, common red flags, and practical strategies to stay compliant. Learn how to run internal audits, document medical necessity, and avoid costly errors before regulators come calling. #WorkersComp #MedicalBilling #AuditCompliance #CaliforniaHealthcare Support the s...

Send us a text Ep. 314 – Navigating OSHA Compliance for Medical Practices in Workers’ Comp OSHA compliance isn’t just for employers. Medical practices treating workplace injuries must follow OSHA rules for documentation, exposure control, training, and staff safety. Anique and Angela break down what providers need to know, common pitfalls, and practical tips for staying compliant while supporting workers’ comp cases. #WorkersComp #OSHA #HealthcareCompliance #MedicalProviders Suppo...

Send us a text Ep. 312 – E-Billing Compliance: Electronic Signatures – Simplifying Workers’ Comp Documentation California’s AB 2337 makes electronic signatures valid for workers’ comp documentation, streamlining billing and compliance. In this episode, Anique and Angela explain what the law requires, how e-signatures improve efficiency, and the compliance rules providers need to follow. Support the show #podcast #newepisode #episode #healthcare #hospitals #medical #workerscomp #attorney #doct...

Send us a text Ep. 311 – E-Billing Compliance: Avoiding Liberty Mutual’s e-EOR Violations California law requires insurers to send compliant electronic Explanations of Review (e-EORs) when providers submit electronic bills. But Liberty Mutual is failing to follow the rules. In this episode, Max and Angela break down the law, highlight Liberty’s violations, and share tools providers can use to enforce compliance and protect their revenue. #WorkersCompUnwrapped #WorkersComp #EBilling #EOR #Cali...

Send us a text Workers’ Comp Unwrapped Episode 310: California’s AB 1870 updates workplace poster requirements starting January 1, 2025. Max and Angela break down what multi-role practices need to do to stay compliant, from updated postings and multilingual versions to placement strategies. Discover how to prevent fines and disputes with this straightforward yet essential compliance checklist. #WorkersComp #CaliforniaLaw #AB1870 #Compliance #HealthcareProviders Support the show #podcast ...

Send us a text Workers’ Comp Unwrapped Episode 309: Dive into California’s 2025 medical-legal fee schedule updates and what they mean for providers. Learn documentation strategies, accurate coding practices, timeline management, and tips to maximize reimbursements. Plus, uncover common pitfalls to avoid and how to challenge underpayments effectively. #WorkersCompUnwrapped #Episode309 #WorkersComp #MedicalLegal #CaliforniaBilling #FeeSchedule2025 #MedicalBilling #ReimbursementStrategies #Billi...

Send us a text Workers’ Comp Unwrapped Episode 308: Explore billing for freelance worker injuries under SB 988 in California. Learn verification steps, documentation requirements, and billing best practices to ensure compliance and timely reimbursements. #WorkersCompUnwrapped #Episode308 #WorkersCompBilling #FreelanceWorkers #GigEconomy #IndependentContractors #HealthcareReimbursement #MedicalBilling #BillingCompliance #CaliforniaWorkersComp #InsuranceBilling #ReimbursementTips #ProtectFreela...

Send us a text Workers’ Comp Unwrapped Episode 307: Navigating gig worker injuries under California’s Proposition 22 can be tricky for providers. In this episode, Max and Ayesha break down the rules for billing, common claim challenges, and strategies to maximize reimbursements while staying compliant. Learn how to handle approvals, coding, documentation, and appeals for gig worker claims. #WorkersComp #GigEconomy #Proposition22 #WorkersCompUnwrapped #MedicalBilling #RevenueCycle #Claim...

Send us a text Ep. 306 – Billing for Vocational Rehabilitation Services in Workers’ Comp Injured workers often need vocational rehab to get back to work—but how do you bill for those services correctly in workers’ comp? In this episode, Max and Ayesha explore the ins and outs of billing for voc rehab services, including the correct codes, documentation requirements, and common billing mistakes to avoid. Learn the key strategies to ensure your voc rehab claims get paid without delays or denia...

Send us a text Ep. 305 – Higher Disability Payments: Optimizing Billing for TTD Increases The California TTD rate is rising 3.8% in 2025—good news for injured workers, but a billing challenge for providers. In this episode, Max and Ayesha explain how the new rates affect medical billing, med-legal evaluations, and claim timelines. Learn best practices to stay accurate, avoid disputes, and keep collections moving. #WorkersCompUnwrapped #TTD2025 #CaliforniaWorkersComp #MedicalBilling #TTDIn...

Send us a text Ep. 304 – New Physician and Pharmaceutical Fee Schedules: What’s Changing in 2025 California’s DWC has released updated physician and pharmaceutical fee schedules for 2025. In this episode, Max and Ayesha unpack the new CPT codes, drug pricing benchmarks, and conversion factors, and explain how accurate coding prevents denials and maximizes reimbursements. Learn what’s changing, common mistakes to avoid, and how to prepare your billing team for a smooth transition. #Podcast #...

Send us a text Ep. 303 – Impact of the 2025 Pure Premium Rate Increase on Provider Billing The WCIRB has approved an 11.2% increase to the 2025 pure premium rate—but what does that mean for California medical providers? In this episode, Max and Ayesha break down the ripple effect this has on reimbursement, preauthorization, denials, and provider billing strategy. Learn how to strengthen documentation, reduce revenue loss, and prepare your workflow for a more aggressive payer environment. 🎙️ ...

Send us a text Ep. 302 – Liberty Mutual’s Excessive Refund Requests: How to Fight Back Liberty Mutual has been sending refund requests for authorized, properly billed medical services, but do you really have to pay them back? In this episode, Max and Ayesha break down the legality of these demands, explain how to challenge them through California’s Independent Bill Review (IBR) process, and share real cases where providers successfully fought back. Learn what the law says, how to respond to r...

Send us a text Ep. 301 – Navigating PPO Contracts and Silent PPOs: Maximizing Revenue In this season opener, Max and Ayesha break down the world of PPO contracts and expose the hidden impact of silent PPOs on your workers’ comp reimbursements. Learn how to identify unauthorized discounts, challenge underpayments, and protect your revenue using the tools and regulations available to California medical providers. Whether you're a doctor, biller, attorney, or employer—this is your playbook...

Send us a text Subtitle: If You Don’t Update the Claim, You’re Updating Your Write-Off List In this episode of Workers Comp Unwrapped, Max is joined by Ayesha to break down why timely and accurate claim amendments are essential in California workers’ compensation. From new diagnoses and expanded body parts to treatment plan changes, they cover when and how to file amendments to avoid denials, delays, and lost revenue. Get actionable steps, real-world examples, and insider tips on staying comp...

Send us a text In this episode of Workers Comp Unwrapped, Max and Ayesha dive into the frustrating world of post-acute care claim denials, where even the most necessary treatments can be deemed "not medically necessary." They explore common reasons for denials, including lack of prior authorization, coding errors, and medical necessity disputes. Ayesha shares strategies to prevent denials, offering insights into how to submit better claims and fight back when denials occur. From home health c...

Send us a text In this must-listen episode, Max and Ayesha dive into the critical documents every provider, employer, and insurer must have to stay compliant—and paid—in California’s workers’ comp system. From first reports to lien filings, discover the exact forms, legal requirements, and common documentation pitfalls that can cost thousands in denied claims and penalties. Whether you're new to workers' comp or overdue for a documentation overhaul, this episode breaks it down with clarity, c...

Send us a text In this episode of Workers Comp Unwrapped, Max and Ayesha break down the most important—and often missed—deadlines in California workers’ comp. From bill submissions to lien filings and UR appeals, every stage of the claims process has a strict timeline. And missing even one can mean losing your right to payment. Ayesha shares practical tips to avoid common mistakes, track critical dates, and implement systems that prevent revenue loss. Whether you’re billing, appealing, or fil...

Send us a text In this episode of Workers Comp Unwrapped, Max and guest expert Ayesha dive into the real impact of Maximum Medical Improvement (MMI) on providers. While MMI signals medical stability for injured workers, it opens a new chapter of billing challenges, lien deadlines, and heightened scrutiny for healthcare providers. Learn what MMI truly means under California law, how it affects treatment approvals, and why failing to act quickly post-MMI can jeopardize your payments. Ayesha sha...

Send us a text 🎙 Workers Comp Unwrapped – Episode 223 Title: Collaborative Strategies Between Adjusters, Attorneys, and Providers Subtitle: Because "We Didn’t Get Your Email" Isn’t a Strategy This week, Max sits down with Ayesha to unpack why poor communication keeps claims delayed and payments missing—and what providers can do about it. From broken email chains to lost authorizations, they explore how early, consistent collaboration between adjusters, attorneys, and providers can speed up ...