Independent Bill Review (IBR) Update 2023 Q1 - 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 382 328 341 285 238 283 256 283 273 263 254 236 3,422
Total Number of Applications Deemed Eligible in the Month 200 187 296 310 246 255 259 315 216 240 277 254 3,055

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 Services 1,764
Physician Services 751
Hospital Outpatient Department & Ambulatory Surgical Centers 553
Medical-Legal Fee Schedule 336
Contract for Reimbursement Rates 165
Pathology & Laboratory Services 91
Inpatient Hospital Services 42
Pharmaceuticals 5
Durable Medical Equipment, Prosthetics, Orthotics & Supplies 3

Case Outcomes

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

There were 3,004 case decisions issued in 2023. The 2,855 overturned cases issued total approximately $3.9 million in additional reimbursement to the IBR applicants.

Disposition Total Count
Overturned Case Decision 2,855
Upheld Case Decision 149
Ineligible Application 1,520
Withdrawn Application 107
Total 4,631

January 2024