With all its acronyms and technical terms, the California medical billing system can be confusing for the uninitiated. For example: What is SBR in medical billing? In today’s post, we answer this question and discuss other useful facts about medical legal billing.
What Is SBR in Medical Billing?
In the California medical billing system, the acronym SBR stands for Second Bill Review.
The Second Bill Review is a process healthcare professionals can use dispute the amount paid by a claims provider (usually an insurance company) for medical-legal expenses.
Here are some basic points healthcare professionals should keep in mind when requesting a Second Bill Review:
- SBR must be requested within 90 days of the service of the Explanation of Review (EOR) giving the reasons why the initial bill was reduced or denied.
- Providers must fill out the form “Provider’s Request for Second Bill Review,” available online here
- Within 14 days of receiving the SBR, the claims provider has to respond with an Explanation of Review.
What Happens After SBR?
If during the SBR process it is determined that any amount is payable, the claims provider has to settle said amount within 21 days of the request of SBR.
However, it’s not uncommon for healthcare providers to disagree with an SBR. In that case, the provider can request an Independent Bill Review, which is a non-judicial process for resolving medical-legal billing disputes.
We explain the SBR/IBR process in detail (including the fees to pay) in this previous post.
Here are other articles to help you learn more about SBR: “California Medical Legal Billing: What Is an EOR?” “Medical Legal Billing in California: Bill Proposes Change to Independent Bill Review (IBR) Fees,” and “7 Essential Terms To Understand Medical Legal Billing in California.”
Practice IQ: Medical Billing Services in California
Need help navigating the SBR process? At Practice IQ, we have made it our mission to take care of the administrative side of medical-legal reports and billing so you can focus on what you do best.
We are located in Pomona, California, and serve clients all over the Golden State. Contact us today by telephone (424-433-5704) or email (piqusinfo@practiceiqusa.com), or fill out the contact form to learn more about our services.
