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UB-04 Expected Reimbursements

DaisyBill automatically calculates Charge amounts using the fees set by California workers’ comp fee schedules. When the state changes reimbursement amounts, DaisyBill recalculates Charge amounts as of the effective date of service.

Use Expected Reimbursements to override DaisyBill’s automatic Charge calculations and create your own.

When a designated Procedure Code is assigned an Expected Reimbursement amount, the Expected Reimbursement amount automatically populates future Bills with the assigned code.

Step 1. On the navigation bar, click ‘Billing Providers,’ then select ‘Manage Billing Providers’

The Manage Billing Providers feature is limited to users with the Role of Organization Admin.

Step 2. Click the ‘Billing Provider’ name

For DaisyBill accounts with multiple Billing Providers, DaisyBill maintains separate Service Line Item Custom Charges for each Billing Provider.

Step 3. Click the ‘Custom Settings’ tab

Step 4. Click the ‘Expected Reimbursements’ card

Step 5. To import ‘Expected Reimbursements’ from a spreadsheet, click ‘Add’, then select ‘Import’

Step 6. Enter the ‘Expected Reimbursement Name’, ‘Effective’ date, and ‘Expiration’ date, then select the CSV file to import

Note: The CSV file MUST use the column headings ‘procedure_code’, ‘supplemental_data’, ‘modifier’, and ‘amount’.

Step 7. Click ‘Import’

Step 8. To manually enter ‘Expected Reimbursements’, click ‘Add Charges’, then select ‘Manual’

Step 9. Enter the ‘Expected Reimbursement Name’, ‘Effective’ date, and ‘Expiration’ date

Effective and Expiration dates correspond to the dates the Expected Reimbursement should be utilized for your practice.  Multiple Expected Reimbursements can be created with the same Effective and Expiration dates.

Step 10. Enter the ‘Procedure Code’, ‘Modifier’ (if applicable), and ‘Expected Per Unit’, then click ‘Add’

A single Procedure Code (or Procedure Code  and Modifier/Supplemental Data combination) can only exist on one Effective Expected Reimbursement at a time.

Step 11. To view an ‘Expected Reimbursement’, click its name

Step 12. To edit an ‘Expected Reimbursement’, click ‘Edit’

Step 13. Enter the changes, then click ‘Save Changes’

To disable an Expected Reimbursement, select No under Active.  The entire Expected Reimbursement will no longer be used.

Step 14. To add a ‘Procedure Code’, click ‘Add Procedure Code’

Step 15. Enter the information, then click ‘Add’

Step 16. To edit a ‘Procedure Code’, click the ‘Pencil’ icon

You can edit the Expected Per Unit, or deactivate the Procedure Code from your Expected Reimbursement.

Step 17. To view the changes made to a ‘Procedure Code’, click the ‘History’ icon

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