Telehealth Appeals Explained

With California’s introduction of retroactive changes to Places of Service and Fee Schedule adjustments, your practice is likely due a substantial amount of additional revenue. We have streamlined this process by identifying bills that are owed further reimbursements due to these changes.

Step 1. From the DaisyBill Home Screen, click ‘Telehealth Appeals’

Step 2. Review ‘Telehealth Bill Summary’

The Telehealth Bill Summary provides an overview of Telehealth Revenue Due and Bill Count for impacted bills in various statuses.

Step 3.  Review ‘Telehealth Bill List’

The Telehealth Bill List provides detailed information on all bills within your account that are impacted by California’s retroactive telehealth updates.  Telehealth Revenue Due provides the additional balance for the Procedure Code per the retroactive update. Telehealth Appeal provides detail on the applicable appeal reason.  Filter bills by Bill Status and sort by any column heading.  

Step 4. If Bill is in ‘Accepted’ status, and an EOR has been received, Click Post 

These Bills qualify for an appeal but are pending payment information before they are eligible for Second Review.  Once the bill is Posted the status update to ‘Processed’ and then be eligible for Second Review.

Step 5. For bills in ‘Closed’ status, click ‘Review’ to navigate to the bill

Review bill and determine if a second review should be sent.  To send a second review click Open on the bill and then Second Review using DaisyBill’s Suggested (and pre-populated!) Second Review language. 

Step 6. For Bills in Processed status Click ‘Appeal’ to navigate to the Bill and create a Second Review Appeal

From the Bill you can complete a Second Review using DaisyBill’s Suggested (and pre-populated!) Second Review language.

Step 5. When reviewing a Bill, scroll down to the Procedure Code(s) and look for the green ‘Appeal’ flag

Procedure Codes identified with the Appeal icon have not only been identified by DaisyBill as eligible for Second Review they also already include a DaisyBill Suggestion to use on your appeal.

Step 6. Click ‘Second Review’ to create a Second Review Appeal

Step 7. Check the box to the left of any Procedure Codes to Second Review

For any Procedure Codes with the green Appeal flag the Reason for Requesting Appeal  will automatically populate with DaisyBill Suggested language.  Click Save when finished.

To use your own appeal language click the Custom Appeal Reason tab.

Step 8. Review your appeal language and Send

If everything looks good, send your appeal by clicking Send

Get ready to collect more revenue!

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