SBR - Second Bill Review

5.7 Second Bill Review

Suppose the provider disputes the amount of payment made by the claims administrator on a bill for medical treatment services; the provider may request the claims administrator to conduct a second review of the Bill.

• The Second Bill Review tab will enable a pending balance in the first Bill. An example is given below. The payment response shows two bill line items submitted for a claim, but only one was paid. In this case, the SBR will open. 

• Go to Billing and Click Second Bill Review on the tab as shown below. 

• The second Bill Review is now open. Scroll down, go to Second Bill Review - Bill Items, and check the pending bill line item. Enter the reason for SBR and upload supporting documents for this bill line. Once all the necessary information is added, click Save. 

• Download the documents needed for SBR from the Report Documents tab, fill them and upload them back in this section. You can also add a custom document in this tab by clicking Add Custom Document. 

• Once all the information is given, and necessary documents are attached, submit the Bill by clicking on Submit Bill and Report. Insurance Company is automatically checked for this Bill, click Download Bill and Report to submit SBR manually or click Bill On Demand to send Bill through the vendor.

• The second Bill Review is sent requesting the balance. If sent manually, please enter the payment response and close the Bill once you receive the payment.