California law already anticipates that someone other than the evaluator will organize the records. It is specific about what that person may do, and about what the physician still has to do afterward.
Medical Chronologies for QME and AME Evaluators: What Makes a Chronology Report-Ready Read Post »
Healthcare revenue cycle automation has come a long way. Not long ago, revenue cycle professionals were spending hours verifying insurance, checking the status of claims, applying payments, and following up on denials.
Why Revenue Cycle Automation Still Needs Human Expertise in the Loop? Read Post »
The Division of Workers’ Compensation’s 2026 IMR Report: Analysis of 2025 Data breaks Q4 2025 case dispositions down by region. Bay Area cases were upheld 85.7% of the time. Los Angeles, 88.4%. Central Valley, 87.5%. Inland Empire, 87.7%. Across 37,872 cases and eleven regions, the spread between the most and least favorable venue was under five points.
The case for AB 1293 was easy to make. A panel QME issues a report that never addresses apportionment, or answers causation for the shoulder and says nothing about the cervical spine. Somebody requests a supplemental report, which the evaluator has 60 days to produce. Somebody else notices the deposition, which can be set as far out as 120 days. Months come off the claim, the per-page and per-report billing keeps running, and the underlying medical opinion has not moved.
Before California’s QME Template Arrives, Fix the Record Set Behind It Read Post »
The rise of healthcare revenue cycle automation is being driven by increasing hospital labor costs, denial volumes, and payer complexity, which are all growing at a rate greater than that of staffing budgets.
What is Driving the Sudden Rise in Revenue Cycle Automation? Read Post »
Three years ago, telling a workers’ compensation defense firm that AI could build a medical chronology was a sales pitch. Today it is an assumption. Every serious vendor in this market has an extraction engine, and most have had one long enough to have worked the obvious bugs out of it.
It arrived as a budget trailer bill, so it moved through the budget process rather than the ordinary policy committee route, and it makes the largest change to the Subsequent Injuries Benefits Trust Fund in decades. It adds Labor Code sections 4750, 4754.1, 4754.2, 4754.3, 4757, and 4758, amends sections 4751, 4753, 4753.5, 4754, and 4755, and makes the 60-day reconsideration rule in section 5909 permanent.
SB 171 and SIBTF: What Changed, What Is Being Misread, and How to Screen Your Open Files Read Post »
A fast chronology and an accurate one are always different. For TPAs, the difference shows up on the reserve line long before it ever shows up on an invoice.
Medical Record Review: The Reserve Accuracy Problem Read Post »
WC examiners rate the paperwork, not the injury. The applicant attorney’s medical record review checklist for QME and IME exams, and why it moves awards.
Workers Comp Medical Record Review for Applicant Attorneys Read Post »
Most medical record reviews are built for the plaintiff’s demand letter, which means it glides right past the facts that a defense file is won. Here are the seven gaps that inflate reserves, and how to catch them before the demand lands.
7 Medical Record Review Gaps That Tank PI Defense Files Read Post »
