Independent Bill Review (IBR) Update 2024 Q1

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 215 235 290                   740
Total Number of Applications Deemed Eligible in the Month 226 238 211                   675

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 394
Physician Services 199
Medical-Legal Fee Schedule 73
Hospital Outpatient Departments and Ambulatory Surgical Centers 32
Contract for Reimbursement Rates 24
Pathology and Laboratory Services 12
Inpatient Hospital Services 5
Durable Medical Equipment, Prosthetics, Orthotics and Supplies 1

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 68 case decisions issued in 2024. The 63 overturned cases issued total approximately $46,000 in additional reimbursement to the IBR applicants.

Disposition Total Count
Overturned 63
Upheld 5
Open 618
Ineligible 45
Withdrawn 9
Total 740

April 2024