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DaisyBill Clients Approach $20 Million in Second Review Revenue

June 1, 2017 by Catherine Montgomery

We have some exciting news to share from the world of California workers’ comp billing. Work comp professionals using DaisyBill software are fast approaching a major Second Review (SBR) milestone. Before the end June, we project that our clients will have collected a total of $20,000,000 in additional revenue by submitting SBRs to appeal incorrect reimbursements. As of this writing, an eye-popping $19.2 million has been collected by our clients submitting electronic Second Reviews. As more and more new DaisyBillers across the state continue to embrace the power of the Second Review, this dazzling collection pace is only speeding up – DaisyBillers are collectively pulling in close to $1,000,000 per month from appeals.

Long-time readers are accustomed to our advocacy for Second Reviews. SBRs are the only way to appeal incorrect payments for all California workers’ comp bills, including medical treatment, medical-legal, copy service and interpreter services.

With our software, it takes DaisyBillers about sixty seconds to submit an electronic request for Second Review. Since SBRs so often lead to corrected payment, that’s a minute well-spent. What’s more, DaisyBill data clearly demonstrates that electronic SBRs deliver fast, consistent payment. Remember, Labor Code 4603.2. (e)(3) mandates that a final EOR is due “within 14 days of a request for second review,” while payment “shall be made within 21 days of receipt of the request for second review.”[1] 

To commemorate the pending $20 Million milestone, we took a look at some Second Review data from the first five months of 2017.

Year to date through May 30th, DaisyBillers submitted 42,715 electronic requests for Second Review via our e-billing software. That puts our clients on track to submit over 100,000 SBRs in 2017. for the second year in a row. That’s a terrific number, but it’s buoyed by our top five clients for Second Review submission, who combine for over 50% of the yearly total.[2]

Client

2017 SBR Count

Client 1

11,400

Client 2

4,472

Client 3

3,183

Client 4

1,675

Client 5

1,630

Top Five Total

22,360

We also track payment data for Second Reviews, and publish some of it in our software and on our redesigned website. As of late May, Sedgwick Claims Management Services leads the way in total additional Second Review payment[3]:

Claims Administrator

Amount

Sedgwick Claims Management Services

$3,767,449

Gallagher Bassett

$2,717,646

State Compensation Insurance Fund

$1,120,944

Zurich Insurance North America

$852,284

ESIS, Inc.

$839,497

Speed is important, too. A new page on our website tracks time to payment for all DaisyBill submissions. Simply switch to ‘Table View’ and apply a filter to collect up-to-the-minute Second Review payment data for every claims administrator in the state.

Second Reviews are a powerful tool to hold claims administrators accountable for reimbursement errors, and our data proves that these appeals work. As our clients push towards $20,000,000 in SBR revenue, we encourage providers across the state to take the time to submit Second Reviews – you deserve to be correctly reimbursed for the treatment and services you provide to California’s injured workers.



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[1] Full text of Labor Code 4603.2 here.

[2] Ideally, we’d love to see more balance up and down the list. Of the 161 DaisyBill accounts to submit Second Reviews this year, 45 have submitted 10 or fewer.

[3] This is attributable to two things: First, Sedgwick is one of the largest claims administrators in the state. Second, we received reports of an automated error causing Sedgwick to miskey certain claims, thereby necessitating Second Reviews.

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