Most Recent Articles
Jun 27, 2018
CA Providers: Appeal Denials for Treatment Preceding Liability Decision
Recently, we pointed out that California employers are liable for treatment that precedes the claims administrator’s decision to accept or deny a workers’ comp claim. Before ...
Jun 13, 2018
Liable by Default: Failure to Deny A Claim Means the Claim is Accepted
In California, when it comes to accepting or rejecting an injured employee’s claim, the claims administrator that neglects to issue a decision is still effectively making a d...
May 25, 2018
Data Reveals Importance of Second Review Appeal for Providers
The claims administrator’s Bill Review does not always recommend the correct reimbursement on the first try. Our second review appeal data reveals a staggering amount of reve...
Aug 14, 2015
Second Bill Reviews in 500 Words or Less
Consider this the SparkNotes or Cliff Notes for Requests for Second Review (also known as Second Bill Reviews (SBRs)). You should really read the book but this shortcut will ...
Jun 1, 2017
DaisyBill Clients Approach $20 Million in Second Review Revenue
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 R...
Aug 6, 2014
Second Bill Reviews for Work Comp: Claims Admin Mistakes
A few days ago I posted examples of good and bad SBR EORs returned by claims administrators. Today I’m posting another SBR denial which shows two mistakes that claims admins...
Mar 1, 2018
When is it Appropriate to File a Lien?
A second review appeal isn’t always enough. Sometimes, providers must take further action to secure proper reimbursement.When a second review appeal fails to produce t...
Apr 5, 2018
WCAB Resolves Lien Deadline Issue
Lien claimants who filed required supplemental lien declarations on July 2 or 3 of 2017 wondered: would the Workers’ Compensation Appeals Board (WCAB) agree to adjudicate tho...
Aug 25, 2017
Billers Beware! Submit Second Reviews to Appeal Incorrect Payments
Recently a claims administrator gave a DaisyBill client some horrible advice about appealing an incorrect payment. A representative at Pacific Claims Management, a thi...
Aug 31, 2017
Maximus Gets It Wrong in 99358 IBR Decision
Maximus Federal Services, the arbiter of Independent Bill Review (IBR) for the California Division of Workers’ Compensation (DWC), has denied payment to a provider due to an ...
Sep 25, 2018
IBR Accountability: Claims Admins Fail to Pay Providers
California regulations mandate that when Independent Bill Review (IBR) overturns a claims administrator’s incorrect bill denial or adjustment and finds in favor of the provid...
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Sep 14, 2018
CA Providers: Do Not Alter Bill When Submitting Second Review Appeal
To appeal incorrect reimbursements or bill denials, California providers must submit timely and compliant requests for second review. To date, DaisyBill clients have recovere...