IBR update 2018
Applications Filed
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 | |
|---|---|---|
| Physician Services | 601 | |
|
282 | |
| Medical-Legal Fee Schedule | 127 | |
| Contract for Reimbursement Rates | 112 | |
| Inpatient Hospital Services | 101 | |
| Pathology and Laboratory Services | 81 | |
|
34 | |
| Interpreter | 23 | |
| Pharmaceutical | 18 | |
| Ambulance Services | 0 |
Case Outcomes
- Overturned – The IBRO has determined that additional reimbursement is warranted.
- Upheld – The IBRO has determined that no additional reimbursement is warranted.
The 384 overturned cases issued from applications filed since January 1, 2018 total $1.3 million in additional reimbursement to the IBR applicants.
October 2018