Independent Bill Review (IBR) Update 2024 Q4

Applications Filed

IBR Filings Jan
Feb Mar Apr May Jun Jul
Aug Sep Oct Nov Dec Total
Total Number of IBR Applications Received by the IBR Organization 215 235 291 296 306 355 325 385 320 346 364 513 3951
Total Number of Applications Deemed Eligible in the Month 226 237 211 222 244 252 289 292 277 340 228 342 3160

Applicable Fee Schedule

This is the DWC fee schedule that covers the service for the disputed bill and is used by the IBRO to decide the appropriate reimbursement. Contracts between providers and payers may supersede the DWC fee schedules and are considered separately by the IBRO.

Applicable Fee Schedule Count
Interpreter 2597
Physician Services 745
Medical-Legal Fee Schedule 272
Hospital Outpatient Departments and Ambulatory Surgical Centers 132
Contract for Reimbursement Rates 133
Pathology and Laboratory Services 42
Inpatient Hospital Services 25
Durable Medical Equipment, Prosthetics, Orthotics and Supplies 3
Ambulance Services 2

Case Outcomes

  • Overturned – The IBRO has determined that additional reimbursement is warranted.
  • Upheld – The IBRO has determined that no additional reimbursement is warranted.

There have been 3010 case decisions issued in 2024. The 2795 overturned cases issued total approximately $3.8 million in additional reimbursement to the IBR applicants.

Disposition Total Count
Overturned 2795
Upheld 215
Ineligible 292
Withdrawn 79
Total 3381

January 2025