At daisyNews, we don’t shy away from offering opinions on controversial aspects of workers’ comp. But some things are not controversies or matters of opinion; they’re simply objective facts of the system.

For example, California workers’ comp fee schedules. The Physician Fee Schedule is not subject to interpretation or bias in favor of providers or payers. It simply establishes the reimbursements for medical services in plain, black-and-white numbers.

However, while fee schedules are objective, they are not simple.

The Division of Workers’ Compensation (DWC) does not simply list procedure codes and the reimbursements owed for each service. Instead, over 200 pages of regulations instruct how to calculate those reimbursements. That’s why providers and payers use daisyWizard’s Fee Schedule Calculator to quickly and accurately determine reimbursements.  

But recently, it has come to our attention that a Broadspire lien representative claimed that the daisyWizard Fee Schedule Calculator is unreliable. In the instance below, the defense representative, arguing on behalf of Broadspire, refused to accept the Calculator’s results — reportedly by claiming that daisyBill is biased in the providers’ favor.

In a conversation with daisyBill, this representative accused daisyBill of “tilting the playing field” in favor of providers. Rather than accepting daisyWizard’s accurate calculations, the representative offered their own amateurish calculations based on inapplicable Medi-Cal reimbursement rates.

We are open to debate on any number of issues in this industry. However, regarding OMFS reimbursement calculations, certain alleged professionals are best advised to stay in their lanes.