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| Withdrawn | 9 |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