Second Review
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...
How to Bill for Physician-Dispensed Pharmaceuticals
Feb 15, 2018
How to Bill for Physician-Dispensed Pharmaceuticals
Payments for physician-dispensed drugs are some of the most misunderstood — and incorrectly denied — in workers’ compensation billing. Too often, the employer or insurer’s cl...
Providers: Don’t Accept 2017 OMFS Reimbursement Rates for 2018 Dates of Service
Feb 13, 2018
Providers: Don’t Accept 2017 OMFS Reimbursement Rates for 2018 Dates of Service
Lately, we’ve noticed a problem. Some claims administrators are reimbursing providers incorrectly. Instead of paying the higher 2018 Official Medical Fee Schedule (OMFS), cla...
“Automatic” Authorization, but Denied Bill? How to Appeal the Denial
Feb 7, 2018
“Automatic” Authorization, but Denied Bill? How to Appeal the Denial
The new “automatic” authorization process for workers’ comp is in effect, as of January 1. We’ve discussed this new system extensively on our blog and in our recent webinar, ...
How It Works: Independent Bill Review (IBR)
Oct 19, 2017
How It Works: Independent Bill Review (IBR)
Think about what workers' comp providers go through to obtain correct payment for treating injured workers. Compliant authorization and billing are taxing enough. Appealing i...
The Parity Problem: How Work Comp Favors Insurers Over Providers
Oct 17, 2017
The Parity Problem: How Work Comp Favors Insurers Over Providers
In disputes over payment in the California workers’ compensation system, insurers have an unfair advantage over providers. At every stage of the billing process, the b...
The Provider’s Burden: Appealing Improper Reimbursements
Oct 6, 2017
The Provider’s Burden: Appealing Improper Reimbursements
Worker’s comp billing is hard enough. Four years ago, California passed strict requirements that providers must follow to appeal incorrect reimbursements from insurers...
Claims Administrator Rectifies SBR Error
Sep 15, 2017
Claims Administrator Rectifies SBR Error
Pacific Claims Management responded to our August blog regarding misinformation about requests for Second Bill Review. DaisyBill spoke with a Pacific representative, with who...
Billers Beware! Submit Second Reviews to Appeal Incorrect Payments
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...
DaisyBill Clients Approach $20 Million in Second Review Revenue
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...
Sedgwick Miskeying Some Workers’ Comp Bills
May 30, 2017
Sedgwick Miskeying Some Workers’ Comp Bills
It’s not often that our support team fields a question that we haven’t already seen in some way, shape, or form. Over the years, we’ve built up a rock-solid understanding of ...