Search results for:

Request for Second Review: Add or Change Units/Modifiers

Notice a mistake on a submitted bill?

Once submitted, a Bill cannot be modified, rescinded, or deleted. If you see a mistake, don’t automatically re-submit the bill; it may be denied as a duplicate.

To add or change a modifier or unit, submit a Second Review with the correct information. Per regulation 9792.5.5, submit a Request for Second Review within 90 days of receipt of the EOR.

Step 1. From the Bill Page, click ‘Second Review’

In order to submit a Second Review, a bill must be in Processed status. If the bill is not in Processed status, manually post the reimbursement amount to the original bill. For more help, see the Help Article: Post: Paper EOR.

second review.jpg

Step 2. Select the Service Line Items to Second Review

select service line item to review.jpg

Step 3. Under ‘Reason for Request for Second Review’, insert Omitted Code/Units/Modifiers

Example language: Modifier 25 was inadvertently omitted from the original bill. Please reprocess the bill with modifier 25.

modifier 25.jpg

Step 3. Repeat for all incorrect payments, then click ‘Save’

repeat and save.jpg

Step 4. Attach additional ‘Supporting Documents’ if necessary, then click ‘Submit’

For more information, see the Help Article: Request for Second Review: Add New Supporting Documents

add docs submit sbr.jpg

That was easy!

Was this article helpful?