Appeals3 minUpdated 2026-05-28

The Second Review reason library

A regulation-cited rebuttal for every denial type

The reason library at /wizard/sbr-library pairs each common California WC denial with a canned, regulation-cited rebuttal — PPO/PR-242 reductions (§9789.30(d)), missing-documentation (cite the 277 acknowledgment), MLPRR page count, modifier 93/96, ML202 downgrade, ML200 missed appointment, no-prior-auth diagnostics, $0/pending EORs, PR-2, MPPR, 99070 physician-dispensed drugs, automatically-authorized denials (§4610(b)), and duplicate-SBR. Every reason carries its controlling statute; 6 of the reasons also carry a specific Maximus IBR precedent you can attach (e.g. the PPO §9789.30(d) line, MLPRR page count, modifier 96, ML202 downgrade, missed appointment, and no-auth diagnostics) — the rest cite the regulation alone. Search by denial, statute, or category and copy the rebuttal language.

The one-EOR-one-SBR rule

File exactly one Second Review per EOR, within 90 calendar days of receipt — or the bill is deemed satisfied and the A/R legally vanishes. If the SBR is denied, escalate to IBR within 30 days ($180 fee). Never file multiple SBRs on the same EOR (it's non-compliant). Mindbill auto-selects the right reason from the EOR's adjustment code when you file.

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