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New fee reduction for Workers’ Compensation Independent Medical Review and Independent Bill Review submissions

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

   
 

Standard IMRs involving non-pharmacy claims

 

$420

 

$390

 

Standard IMRs involving pharmacy-only claims

 

$390

 

$345

 

IMRs terminated or dismissed, not forwarded to a medical professional reviewer

 

$160

 

$123

 

IMRs terminated or dismissed after case forwarded to a medical professional reviewer

 

$420

 

$390

 

Expedited IMRs involving non-pharmacy claims (no change in fee)

 

$515

 

$515

 

Independent Bill Review

   
 

Completed IBR

 

$250

 

$195

 

Terminated IBR not sent to review

 

$50

 

$47.50

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.

 

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