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.