Review all EORs processed by Coventry
A DaisyBiller identified an error affecting a portion of bills processed by Coventry from December 13th-15th, 2015.
A Coventry representative described the error as a ‘glitch’ in Coventry’s processing system which caused erroneous contractual adjustments for bills processed from December 13-15, 2015. Coventry incorrectly applied contract discounts, resulting in underpayments to providers.
DaisyBill’s Compliance Team reviewed several EORs affected by the Coventry error and confirmed that only a single line item was paid, with additional lines items denied using the denial reason ‘Network Discount’ or ‘Coventry-Owned Contract.’
Required Action
Carefully review all Coventry-processed Explanations of Review (EORs). Coventry reviews bills for several claims administrators, including Sedgwick.
For Incorrectly Processed Bills
- Upload the paper EOR to the Bill in DaisyBill.
- Submit a request for Second Review for additional payment citing your practice’s correct contract terms.
- Alert DaisyBill’s Compliance Team by opening a Support Case; be sure to include the DaisyBill Bill ID.
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