Second Review / Appeal
Second Review / Appeal

EORs NOT Required for SBR

Last update
September 24, 2023

A daisyBiller reported that The Hartford denied a Second Review (SBR) because an EOR was not attached. This is noncompliant behavior!  

A representative from The Hartford acknowledged that the EOR is not a compliant Second Review requirement. Nevertheless, the automatic bill processing system bypasses review when the original EOR is missing from an SBR. As all daisyBillers know, California regulations require only the SBR-1 Form and the Modified CMS 1500 for a compliant SBR.

See California Code § 9792.5.5(d):

Recommended Action

  1. daisyBill recommends to always upload the EOR to a bill as evidence of payment, and especially when submitting an SBR. Most claims administrators do not require this additional (non-compliant) step. Nevertheless, uploading the EOR will help to avoid unnecessary delays in processing or having to resort to costly Independent Bill Review for those claims administrators who do have this “requirement” of additional documentation.
  2. If you are told that an SBR is denied due to lack of an EOR, call The Hartford (or other claims administrator) to let them know so that they can reprocess the bill.
  3. Also, if you are told that an SBR is denied due to lack of an EOR -- by the Hartford or any other claims administrator -- please let daisyBill know by chatting us in the Help Center. 

We want to improve the workers compensation billing process for everyone involved!  

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