Workers’ Comp Unwrapped

Send us Fan Mail AI is changing the way California providers prepare authorisation requests — but only if you use it the right way. In this episode, Anique and Angela break down how AI can support RFA drafting, help align requests with MTUS standards, and reduce avoidable UR denials and revenue leakages. Learn what AI can and cannot do, how to use it responsibly, and why structured documentation i...

Send us Fan Mail What changed in workers’ comp in 2025 and what do those shifts mean heading into 2026? In this episode, Anique and Angela recap the biggest operational trends from the past year, including denial patterns, administrative friction, technology adoption, and year-end risk. Learn how tighter enforcement and recurring workflow gaps are shaping planning conversations for 2026 — and what...

Send us Fan Mail AI in WC Billing: What’s Actually Working in Real Practices AI is everywhere in healthcare — but workers’ comp has its own rules. In this episode, Anique and Angela cut through the hype to discuss how AI tools are actually being used in real WC billing operations. Learn where AI is helping with documentation review, coding alignment, RFA tracking, and denial visibility — and where...

Send us Fan Mail Year-End Documentation Checklist: What to Wrap Before Jan 1 Year-end doesn’t pause workers’ comp timelines. In this episode, Anique and Angela walk through a practical documentation checklist to help providers close out the year cleanly. From outstanding reports and RFAs to billing, disputes, and lien protection, learn what should be reviewed before January to reduce delays, prote...

Send us Fan Mail Ep. 329 – Holiday Offers in WC: Structuring Seasonal Incentives the Right Way Holiday incentives can feel harmless — but in workers’ comp, they can create serious compliance risk if they’re tied to referrals or volume. In this episode, Anique and Angela break down common holiday offers providers consider, why referral bonuses raise red flags, and how to structure year-end packages...

Send us Fan Mail Ep. 328 – High Frictional Costs in WC: What’s Wasting Time & Money? Workers’ comp inefficiencies often hide in plain sight. In this episode, Anique and Angela unpack the biggest sources of friction in WC administration and billing — from eligibility issues and RFAs to documentation rework and delayed payments. Learn how small operational gaps quietly drive up costs and how sma...

Send us Fan Mail Denials in workers’ comp aren’t random anymore — they’re revealing patterns. In this episode, Anique and Angela unpack 2025 denial analytics to show where payment risk is building, which issues are driving non-payment, and how smarter front-end systems can reduce exposure heading into 2026. Learn how to interpret denial data as feedback — not just frustration — and use it to stren...

Send us Fan Mail Holiday Staffing Gaps: Avoiding Lien Filing & RFA Delays Billing delays spike in December, but workers’ comp deadlines don’t pause. In this episode of Workers’ Comp Unwrapped, Anique and Angela break down how holiday staffing gaps lead to missed RFAs, delayed billing, and lost lien rights. Learn practical strategies to protect timelines, maintain compliance, and avoid January...

Send us Fan Mail Ep. 325 – Telehealth in WC: What’s Working and What’s Getting Denied Telehealth is no longer new in workers’ comp — but in 2025, it’s under more scrutiny than ever. In this episode, Anique and Angela break down how virtual care has evolved post-pandemic, what services are often being approved, and where RFAs and billing are triggering denials. Learn the documentation, RFA language...

Send us Fan Mail Episode 324 – Firefighter PTSD Claims: What’s Blocking Treatment Approval? Firefighters are repeatedly exposed to traumatic events over the course of their careers — yet mental health treatment requests can still face delays or denials in many workers’ compensation systems. In this episode, Anique and Angela examine why firefighter PTSD claims are often more complex than they appe...

Send us Fan Mail Episode 323 – Holiday Injuries & Workers’ Comp: What Seasonal Trends Tell Us The holiday season changes how work gets done—and how injuries occur. In this episode, Anique and Angela break down ordinary holiday-related workers’ comp risk patterns, including fall risk, fatigue-related incidents, and temporary worker injuries, and explain how providers can respond with stronger d...

Send us Fan Mail Ep. 322 – WC Fraud Lessons from 2025: Payroll Schemes, Phantom Claims & Provider Pitfalls What does fraud look like in California workers’ comp today, and how can legitimate providers stay out of trouble? In this episode, Anique and Angela unpack real 2025 enforcement trends, including underreported payroll, phantom billing patterns, and RFA misuse. Learn the documentation and...

Send us Fan Mail  Ep. 321 – Case Study: How One Practice Lost $120K to Documentation Gaps What happens when good care meets poor documentation? In this real case, a California WC provider lost over $120K due to missing notes, recycled RFAs, and late PR-2s. Anique and Angela break down every mistake — and give you the toolkit to avoid the same fate. 🎧 Listen now on Spotify, Apple, YouTube & mo...

Send us Fan Mail Ep. 320 — Long COVID in Workers’ Comp: Billing Strategies for Complex, High-Cost Cases Long COVID cases challenge providers and billing teams with fluctuating symptoms, multi-specialty involvement, and the absence of a dedicated MTUS guideline. In this episode, Anique and Angela explain how to document and code Long COVID conditions, navigate UR, support medical necessity, and pro...

Send us Fan Mail That feeling when Sacramento drops another “update” — and you’re not sure whether anything actually changed. For months, we’ve been reading DWC bulletins, tracking revisions, and waiting to see which Utilization Review amendments will survive the OAL review process. In Episode 319, Anique and Angela finally break it all down: What’s really in the proposed UR changes What was sent...

Send us Fan Mail 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 commun...

Send us Fan Mail 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 Support the show #podcast #newepisode #e...

Send us Fan Mail 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. #WorkersCompUnwra...

Send us Fan Mail 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...

Send us Fan Mail 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 supportin...

Send us Fan Mail 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...

Send us Fan Mail 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 en...

Send us Fan Mail 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. #...

Send us Fan Mail 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 #WorkersCom...

Send us Fan Mail 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 #MedicalBi...