Second Review
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...
Oct 3, 2019
Liberty Mutual and a Cautionary Tale of Payment Woes
Today we’re sharing a maddening and all-too-common story of payment woes, this time featuring Liberty Mutual as the miscreant that just won’t pay a bill correctly -- despite ...
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...
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...
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...
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...
Feb 19, 2019
IBR Appeal Analysis for CPTs 99358 & 99359
**Update: The 2021 OMFS updates drastically changed how E/M codes are billed.*Reimbursements for CPTs 99358 & 99359 are tricky because payers frequently deny reimburse...
Feb 15, 2019
Liberty Mutual Trifecta of Incorrect Payments
In this, our fourth story on the fiasco of 2019 workers’ comp payments, we turn to the errors of Liberty Mutual. By now, from reading about Sedgwick, York, and Sedgwick (agai...
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...
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...
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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...
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 ...