Some claims administrators will return multiple incorrect e-EORs in response to an appeal/SBR bill submission. Typically, these e-EORs consist of a negative e-EOR for the payment made on the original bill submission and a positive e-EOR for both the original bill submission and the appeal/SBR submission.
When this occurs, daisyBill automatically corrects these e-EORs by merging them together and posting only the difference in payment between the original bill submission and the appeal/SBR submission. Read on to learn how to view the details of the original e-EORs.
A. To view details of merged e-eORs, click ‘Merged e-EORs’
B. Review the Appeal/SBR Payment Amount
C. Review the Merged Appeal/SBR Reduction Amount
D. View the Calculated Difference in the e-EOR Posted
A. To view details of merged e-EORs, click ‘Merged e-EORs’
This will expand the Explanation of Review Posted table to display the merged e-EORs.
B. Review the Merged Appeal/SBR Payment Amount
In this example, the claims administrator indicates a payment of $600.00 in further payment.
C. Review the Merged Appeal/SBR Reduction Amount
In order to correct their records, the claims administrator remits a negative amount for the amount paid on the Original Bill. This is not a takeback. In this example, the claims administrator indicates a negative amount of $90.00
D. View the Calculated Difference in the e-EOR Posted
daisyBill calculates the payment difference between the two merged e-EORs and posts only that amount to the bill. In this example, the payment of $600.00 minus the negative $90.00 results in a posted payment of $510.00 for the Appeal/SBR bill submission.
No action is required from you when e-EORs are merged, so you can get back to beautiful billing!