March 17, 2015
Area(s) of Interest: Payor Issues and Reimbursement Practice Management Workers' Compensation
The California Department of Industrial Relations (DIR) announced that fees for submission of an Independent Medical Review (IMR) or Independent Bill Review (IBR) for workers’ compensation were reduced effective January 1, 2015.
The following table summarizes the reduction in fees.
Fee prior to December 31, 2014
Fee effective January 1, 2015
Independent Medical Review
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Standard IMRs involving non-pharmacy claims
Standard IMRs involving pharmacy-only claims
IMRs terminated or dismissed, not forwarded to a medical professional reviewer
IMRs terminated or dismissed after case forwarded to a medical professional reviewer
Expedited IMRs involving non-pharmacy claims (no change in fee)
Independent Bill Review
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Terminated IBR not sent to review
Physicians who submitted an IMR or IBR on or after January 1, 2015, will receive a refund for any fees paid in excess of the new fee schedule.