Denial Incorrect: No Authorization
For incorrectly denied or underpaid Original bills, DaisyBill advises filing a Second Review and including IBR decisions as supporting documentation.
Official Medical Fee Schedule
EOR Denial Reason
The billed service was not authorized by UR.
Second Review Reason (SBR-1 Form)
UR authorized all billed services. Please reprocess this bill and issue payment. Documented authorization submitted with original bill.
The authorization is included with this SBR-1 Form.
Optional: Attached is a copy of an OVERTURN IBR Decision indicating this incorrect denial will be overturned when reviewed by IBR.
Recommended Supporting Documents
- IBR Case Overturn of Denied for Authorization Example 1
- IBR Case Overturn of Denied for Authorization Example 2
- IBR Case Overturn of Denied for Authorization Example 3
- Copy of authorization for services
Webinar: Request for Second Review
Webinar: Second Review Strategy Kit, Part I
Webinar: Second Review Strategy Kit, Part II
Every request for Second Review submitted from DaisyBill is compliantly submitted using both a completed DWC Form SBR-1, as well as a compliant modified CMS 1500.
Was this article helpful?
DaisyBill is a trusted authority on workers’ comp billing. Thousands of work comp professionals attend our webinars and state agencies and professional organizations turn to us for our expertise. We created this blog to help everyone involved in workers’ compensation; sharing news, tips, and data of interest to the community.
Drop us a line with any news you would like us to share or any issue that concerns you.