Independent Bill Review (IBR) Update 2023 - Q2

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 382 328 338 285 238 283             1,854
Total Number of Applications Deemed Eligible in the Month 200 187 296 310 246 257             1,496

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 1,398
Interpreter Services 1,179
Contract for Reimbursement Rates 471
Medical-Legal Fee Schedule 410
Hospital Outpatient Department & Ambulatory Surgical Centers 252
Pathology & Laboratory Services 167
Inpatient Hospital Services 69
Pharmaceuticals 15
Durable Medical Equipment, Prosthetics, Orthotics & Supplies 4

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 1,389 case decisions issued this year. The 1,322 overturned cases issued total approximately $1.75 million in additional reimbursement to the IBR applicants.

Disposition Total Count
Overturned Case Decision 1,322
Upheld Case Decision 67
Ineligible Application 826
Withdrawn Application 54
Total 2,269

July 2023