Second Review
CA Interpreters: No Second Review = No Payment
Dec 2, 2019
CA Interpreters: No Second Review = No Payment
Providers — interpreters in particular — be advised: a California appeals court ruled that claims administrator Meadowbrook Insurance is not required to pay a disputed fee fo...
Berkshire Hathaway Fails to Process Second Review Appeals
Aug 1, 2019
Berkshire Hathaway Fails to Process Second Review Appeals
Berkshire Hathaway Homestate Companies (BHHC) is failing to process electronic second review appeals, leaving providers in an unacceptable payment limbo. The insurer incorrec...
Claims Admins Deny Second Review Appeals as Duplicate Bills
Jul 2, 2019
Claims Admins Deny Second Review Appeals as Duplicate Bills
Two claims administrators, York and Sedgwick, denied hundreds of compliant second review appeals on the grounds that the appeals were “duplicates” of the Original Bills in qu...
Second Review Loopholes Hurt Providers
Mar 27, 2019
Second Review Loopholes Hurt Providers
Our previous articles highlighted claims administrators’ processing speed for original bill submissions. Now, we turn our attention to average days to process Second Review a...
📬 Payer Responses: Guile, Waiting, and Crickets  🏏
Mar 1, 2019
📬 Payer Responses: Guile, Waiting, and Crickets 🏏
Today we report on the responses from Sedgwick, Liberty Mutual, York, and State Compensation Insurance Fund (SCIF), following our posts detailing their systematic underpaymen...
Maximus Confirms Using Second Review Appeals to Correct Billing Errors
Feb 12, 2019
Maximus Confirms Using Second Review Appeals to Correct Billing Errors
Correcting a coding error is as simple as submitting a Second Review appeal explaining the error. Last year, we discussed the convoluted process to correct billing err...
No Response to Second Review Request?  A Lien Is the Only Option
Oct 10, 2018
No Response to Second Review Request? A Lien Is the Only Option
A recent refusal by Travelers Insurance to respond to a provider’s second review appeal, and subsequent denial of the provider’s request for Independent Bill Review (IBR), pe...
CA Providers: Do Not Alter Bill When Submitting Second Review Appeal
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...
CA Providers: Appeal Denials for Treatment Preceding Liability Decision
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 ...
Workers’ Comp Billing Error: Resubmit or Request Second Review Appeal?
May 30, 2018
Workers’ Comp Billing Error: Resubmit or Request Second Review Appeal?
Mistakes happen. When a provider accidentally submits an original bill that contains an error, taking the appropriate action is key to avoiding further delay in reimbu...
Data Reveals Importance of Second Review Appeal for Providers
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...
VPay Error Impacts Thousands of Sedgwick EORs
Feb 23, 2018
VPay Error Impacts Thousands of Sedgwick EORs
VPay, a payment processing company which issues explanation of reviews (EORs) and virtual credit card payments from claims administrators to providers, suffered a technical g...