Independent Bill Review (IBR) Update 2021
|2020- 2021 IBR Filings||Jan||Feb||Mar||Apr||May||June||Jul||Aug||Sep||Oct||Nov||Dec||Total|
|Total Number of IBR Applications Received by the IBR Organization||151||217||241||223||832|
|Total Number of Applications Deemed Eligible in the Month||105||116||184||204||609|
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|
|Medical-Legal Fee Schedule||96|
|Hospital Outpatient Department & Ambulatory Surgical Centers||83|
|Contract for Reimbursement Rates||46|
|Pathology & Laboratory Services||36|
|Inpatient Hospital Services||24|
|Durable Medical Equipment, Prosthetics, Orthotics & Supplies||2|
- Overturned – The IBRO has determined that additional reimbursement is warranted.
- Upheld – The IBRO has determined that no additional reimbursement is warranted.
There have been 522 case decisions issued in 2021. The 475 overturned cases issued total $652,000 in additional reimbursement to the IBR applicants.
|Overturned Case Decision||475|
|Upheld Case Decision||47|