Employers who utilize California Insurance Company (Applied Risk) to provider workers compensation coverage for their employees will no longer be able to refer their injured workers to Stacy Medical Center or Alameda Industrial Medical Group for comprehensive medical and surgical care. Stacy Medical Center and Alameda Industrial Medical Group will not evaluate or treat patients covered by California Insurance Company (Applied Risk) unless the employer agrees to follow labor code 3753 [3753 The person entitled to compensation may, irrespective of any insurance or other contract, except as otherwise provided in this division, recover such compensation directly from the employer] and reimburse the clinic for authorized services provided to their injured employees but denied by California Insurance Company (Applied Risk). The patient in question was referred to our clinic with the EMPLOYERS TREATMENT AUTHORIZATION "in hand". The patient was suffering from a lumbar disc herniation and was in severe pain. In good faith, an exam was performed, treatment was rendered and medication was dispensed. The EOB displayed in this document clearly demonstrates the disregard California Insurance Company (Applied Risk) has for the bills submitted to them for payment and blatant abuse of the "bill review" process in the workers compensation system. While the majority of insurance companies cooperate and reimburse for services rendered according to the California published fee schedules CALIFORNIA INSURANCE COMPANY (APPLIED RISK) REFUSES to do so.
WE STRONGLY ENCOURAGE OUR CLINENTS NOT PURCHASE OR RENEW WORKERS' COMPENSATION INSURANCE COVERAGE WITH CALIFORNIA INSURANCE COMPANY (APPLIED RISK) UNTIL SUCH TIME THEIR BUSNIESS POLICIES CHANGE TO BETTER SUIT THE NEEDS OF YOUR INJURED WORKERS.