Blog: DaisyBill News

Our previous articles highlighted claims administrators’ processing speed for original bill submissions. Now, we turn our attention to average days to process Second Review appeals.

Last year, to dispute an incorrect reimbursement or denied payment, DaisyBill clients submitted more than 123,400 Second Review appeals.

DaisyBill tracks California claims administrators and their respective clients to ensure that electronic bills are consistently routed to the correct payer for processing.

Last year, for facility bills submitted through DaisyBill payment was received, on average, in 17 days for the top 20 California workers’ comp claims administrators.

Unfortunately, that average exceeds the mandated maximum allowed for bills submitted electronically.

DaisyBill’s electronic billing software allows us to comprehensively compile data on every bill we process.

Last year, more than 107,000 interpreter and copy service bills were processed by DaisyBill. The top 20 claims administrators took an average of 10 business days to process these bills.

DaisyBill’s electronic billing software allows us to track detailed statistics on payments and denials, including speediness of payment amounts. 

In 2018, for California medical-legal bills submitted using DaisyBill software, the average processing time is 13 business days to receive payment for the top 20 claims administrators by volume. Last week, we published the data for medical treatment bills, which were processed even faster, in just 11 days.

Listed by volume of processed bills from January 1 through December 31, 2018, the statistics below reflect payment speed -- the average number of business days between the electronic submission of a medical-legal bill and receipt of the explanation of review (EOR) -- for the 20 top claims administrators.

In 2018, for California medical treatment bills submitted using DaisyBill software, the average processing time is 11 days for the top 20 claims administrators by volume. We’ll take a closer look at the fastest and slowest claims administrators, as well as list the averages for the rest of the top 20.

Not one to avoid the spotlight, York Risk Services joins Sedgwick CMS in incorrectly applying the 2018 Physician Fee Schedule rates to services rendered in 2019. Our data show a consistent and demonstrated pattern of botched payments through at least the end of January.

Despite the vastly increased complexity of the California Physician Fee Schedule in 2019, most administrators are abiding by the changes and issuing checks for the appropriate amounts. A few stragglers remain who, for whatever reason, fail to follow the new schedule. Today, we turn our attention to York Risk Services.

For 2019 beloved psychological testing codes 96101 and 96102 have vanished.  

Effective for dates of service on or after January 1, 2019, the Medicine/Central Nervous System Assessments/Tests subsection of the Current Procedural Terminology (CPT®) 2019 eliminated CPT codes 96101 and 96102. The Current Procedure Terminology (CPT®) 2019 replaces these two codes with seven new replacement CPT codes.

This 2019 change has left many providers with many questions, so we made some handy charts to answer them!