IBR update 2020

Applications Filed

2020 IMR Filings Jan Feb March April May June July Aug Sept Oct Nov Dec Total
Total Number of AIBRpplications Received by the IBR Organization 163                       163
Total Number of Eligible IBR Applications 116                       116

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 106
Hospital Outpatient Department & Ambulatory Surgical Centers 38
Contract for Reimbursement Rates 25
Medical-Legal Fee Schedule 10
Inpatient Hospital Services 7
Pharmaceuticals 3
Durable Medical Equipment, Prosthetics, Orthotics & Supplies 1
Pathology & Laboratory Services 1

Ambulance Services and Interpreter Services

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 121 case decisions issued in 2020. The 70 overturned cases issued since January 1, 2020 total $269,365 in additional reimbursement to the IBR applicants.

Disposition Total
Overturned 70
Upheld 16
Ineligible 24
Withdrawn 11
Total 121

February 2020