Workers’ compensation underpayments are not outliers. They are systematic, predictable, and too often unchallenged.

For medical providers, the problem is not identifying that a payment is wrong. The problem is proving it quickly, cleanly, and in compliance with state rules. Especially in California, where fee schedule precision and Second Review requirements leave little room for error.

daisyBill solves that problem at the point of payment posting.

Real-Time Fee Schedule Validation By Procedure Code

When a payment is posted in daisyBill, the system automatically displays the expected reimbursement amount for each individual procedure code, calculated using the applicable workers’ compensation fee schedule.

This is not an estimate. It is a rule-based calculation tied directly to the governing schedule.

For each line item, daisyBill shows:

• The expected fee schedule amount
• The amount actually paid
• The remaining balance due
• The percentage of the fee schedule paid by the claims administrator

If a carrier pays 72 percent of the fee schedule, daisyBill shows it. Immediately.

Automatic Balance Due Calculation

daisyBill calculates underpayment automatically by subtracting the original submission payment from the expected fee schedule amount.

Example:

• Expected fee schedule amount
• Minus payment received
• Equals balance due of $29.11

No spreadsheets, manual math, or second guessing.

The underpayment is documented at the procedure-code level, which matters when disputes escalate.

Second Review Appeals in California: Completed in 30 Seconds

In California, disputing incorrect reimbursement requires submitting a Second Review appeal with precision. daisyBill compresses what used to take hours into seconds.

The workflow is simple:

1. Click Second Review
2. Select the procedure code
3. Enter the dispute reason
4. Click Save

At that moment, daisyBill automatically captures the data and completes the SBR-1 form for you.

No rekeying, missing fields, or formatting errors.

Click Send, and the Second Review appeal is submitted instantly.

Total time: 30 seconds or less.

Why This Matters: Scale and Recovery

Most underpayments are small enough to be ignored, but large enough to matter in aggregate.

daisyBill providers have collectively recovered over $100 million in improperly withheld workers’ compensation payments using Second Review appeals.

That recovery did not come from aggressive tactics. It came from:

• Accurate fee schedule enforcement
• Clean documentation
• Fast, compliant disputes
• Consistent follow-through

Built for Compliance, Designed for Leverage

daisyBill does not just show that a payment is wrong. It shows exactly how wrong it is, why, and what to do next, using the same standards payers are required to follow.

For providers operating in California workers’ compensation, that leverage is the difference between absorbing underpayments and correcting them. Correction should not take longer than the mistake itself.

For more information on better, beautiful billing, contact info@daisybill.com. 

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