Workers’ Comp Unwrapped
Workers' Comp Unwrapped with Max Cooper is your go-to podcast for uncovering the complexities of the workers' compensation system. Join Max Cooper, an experienced industry professional, as he breaks down the latest trends, tips, and case studies in workers' comp, making it easier for business owners, HR professionals, and employees to navigate. From understanding your rights to exploring key legal developments, Max unwraps the essential information you need to know, all in an engaging and straightforward way. Tune in for insightful discussions, expert interviews, and actionable advice to help you manage workers' comp more effectively!
Episodes
Ep. 318 — Appealing IMR Delays: Strategies for Faster Resolutions
IMR delays can stall treatment and frustrate patients. Join Anique and Angela as they break down why IMR delays happen and how providers can speed up the process. Learn actionable strategies to reduce turnaround times using proactive documentation, MTUS-based justification, strict timeline tracking, and clear communication with adjusters.
#WorkersCompUnwr...
Denied post-acute care claims are common, but avoidable.
In Episode 317, Anique and Angela break down why denials happen, the documentation insurers actually want, and how to appeal successfully using MTUS-aligned, detailed clinical evidence.
#WorkersCompUnwrapped #WorkersComp #PostAcuteCare #MedicalBilling #ClaimDenial #CaliforniaProviders
#podcast #newepisode #episode #healthcare #ho...
Ep. 316 – Overcoming UR Denials in 2025
California’s UR rules have evolved, and so should your strategy. Anique and Angela break down how to write RFAs that get approved, avoid common denial traps, and navigate Independent Medical Review (IMR) successfully. Learn the latest 2025 updates, timelines, and documentation tips to secure treatment authorizations faster.
#WorkersCompUnwrapped #CaliforniaWorkersComp #U...
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 #Medica...
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.
#Worke...
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.
#podcast #newepisode #episo...
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 reve...
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 #Comp...
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 #FeeS...
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 #CaliforniaWork...
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 #Wor...
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 ...
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.
#WorkersCom...
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 pre...
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 p...
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 succe...
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&apos...
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 action...
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 sub...
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...
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