bill review

Claims Admin Directory - New Free Resource!
Apr 4, 2022
Claims Admin Directory - New Free Resource!
Knowledge is power, and sunshine is the best disinfectant. Nowhere are these principles more true than in workers’ compensation, where for too long a convoluted, opaqu...
San Francisco Changes Bill Review, e-Bill Resubmissions Required
Feb 28, 2022
San Francisco Changes Bill Review, e-Bill Resubmissions Required
Starting February 28, 2022, Allied Managed Care replaces EK Health as the bill review vendor for the City and County of San Francisco (CCSF). Accordingly, providers must subm...
City of Pasadena: CompIQ Saves the Day
Aug 10, 2021
City of Pasadena: CompIQ Saves the Day
Following a switch to a new third-party claims administrator (TPA), the City of Pasadena violated California law by suddenly failing to accept electronic bills for the treatm...
Provider Warning: Prime Health Services (Part I)
Apr 19, 2021
Provider Warning: Prime Health Services (Part I)
Recently, a provider made the unfortunate mistake of signing a Prime Health Services (PHS) Preferred Provider Agreement contract, commonly known as a PPO agreement. While not...
Bill Review Highlight: Definiti Healthcare Management
Nov 3, 2019
Bill Review Highlight: Definiti Healthcare Management
Over the last several years, providers have sent over 5.2 million workers’ comp bills from DaisyBill. These millions of bills allow DaisyBill to directly witness the manageme...
York EORs Create Revenue Management Headaches
Oct 17, 2019
York EORs Create Revenue Management Headaches
York Insurance has repeatedly reported incorrect payment amounts in recent Final Explanations of Review (EORs), which are issued in response to second review appeals. These F...
Farmers Insurance Switches Bill Review
Oct 16, 2019
Farmers Insurance Switches Bill Review
Effective October 14, Farmers Insurance switched bill review services, from CorVel to Mitchell.This change affects bills for all dates of service. Claim numbers remain...
San Francisco MTA Switches Bill Review
Sep 12, 2019
San Francisco MTA Switches Bill Review
San Francisco Municipal Transportation Agency (SFMTA) switched bill review services, from Mitchell to EK Health.The change is effective August 29, and affects bills fo...
Technical Difficulties Trouble San Diego Bill Review Switch
Aug 26, 2019
Technical Difficulties Trouble San Diego Bill Review Switch
The City of San Diego, a self-insured, self-administered California employer, is in the process of switching bill review services from Genex to Medata. The transition, though...
NonCompliant CNA, Crum & Forster, County of San Diego - Electronic EORs Not Optional
Aug 8, 2019
NonCompliant CNA, Crum & Forster, County of San Diego - Electronic EORs Not Optional
As California continues its transition to fully paperless workers’ comp billing and payment, some claims administrators have apparently decided to follow their own regulation...
Mitchell Unresolved EOR Mess
Jul 17, 2019
Mitchell Unresolved EOR Mess
A persistent glitch in Mitchell’s bill review service is causing revenue management chaos for providers. For second review appeals, providers receive electronic explanations ...
Ultrasound Documentation: Images NOT Required
May 30, 2019
Ultrasound Documentation: Images NOT Required
At DaisyBill, our clients ask us for help when claims administrators improperly deny reimbursement. Recently, our clients have reported that some claims administrators are de...