Should I submit a corrected bill or request second review?

There are processes for submitting corrected electronic and non-electronic original bills. However, both processes are unreliable. We recommend taking one of the following actions instead:

  • If you mistakenly left out a procedure code(s) or under-reported the number of units, simply submit an original bill ONLY for the missing procedure code(s) or the additional units of service.
  • To correct a coding error on the bill, use the second review appeal process. Just wait for the Explanation of Review (EOR) from the claims administrator before initiating the second review appeal.

Theoretically, providers can resubmit corrected bills. Instructions for doing so are located in the  DWC Medical Billing and Payment Guide for non-electronic bills, and the Electronic Billing and Payment Companion Guide for electronic bills.

However, the guidelines for bill resubmission are contradictory, and the provider may not know if the EOR has already been sent by the claims administrator, which renders the corrected bill invalid.

The two options above are far simpler, and more likely to result in correct payment. For more detail, see our blog.

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