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DIR reduces fees for Independent Medical Review and Independent Bill Review



May 29, 2014
Area(s) of Interest: Payor Issues and Reimbursement Practice Management 

he Department of Industrial Relations (DIR) has announced a reduction in the fees associated with the Independent Medical Review (IMR) and Independent Bill Review (IBR) processes effective April 1, 2014.

The following table summarizes the reduction in fees.

  Fee prior to April 1, 2014 Fee effective April 1, 2014
Independent Medical Review    
Standard IMRs involving non-pharmacy claims $560 $420
Expedited IMRs involving non-pharmacy claims $685 $515
Standard IMRs involving pharmacy only claims N/A $390
IMRs terminated or dismissed not forwarded to a medical professional reviewer $215 $160
IMRs terminated or dismissed after case forwarded to a medical professional reviewer $560 $420
Independent Bill Review    
 

Completed IBR

 $335  $250
Terminated IBR not sent to review  $65  $50

 

Physicians who submitted an IMR or IBR on or after April 1, 2014, will receive a refund for any fees paid in excess of the new fee schedule.

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