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News, data, & insights about workers' comp billing

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Providers, File Those Independent Bill Reviews (IBRs)!

September 20, 2014 by Catherine Montgomery

Recently I heard Dr. Rupali Das speak at the CWC & Risk Conference--she’s the DWC Executive Medical Director. Her very interesting presentation started me thinking about workers’ compensation IBRs, along with Richard Boggan’s posts about the process.

My understanding from Dr. Das’ presentation is that the DWC is encouraging providers to take advantage of the IBR process to resolve payment disputes.  DaisyBill agrees that the IBR process is under-utilized and we would like to see providers better use the IBR venue when their bills are incorrectly processed.

The IBR process is working better since its rocky start and cases have been making their way through Maximus at a steady clip.  Here’s all the IBR decisions thus far.

Providers should realize what an incredibly powerful process IBRs can be, not only for getting paid for a particular bill but also for setting up a precedent for future bills.  Again, I’ll point you to Richard Boggan’s informative writings.  

For those who aren’t too familiar with the IBR process, here’s Maximus’ May slideshow on the IBR process.  This the DWC’s IBR Page; and this is the IBR Form itself.  As further encouragement, remember that IBR filing fees recently dropped to $250, effective to April 1, 2014.

Stay tuned to DaisyBill as we’re planning an IBR webinar in the near future.

By the way, we’re giving a webinar this Wednesday, September 24, on DMEPOS, E/M Visits, and  Dispensed Pharmaceuticals.  One of the topics we’ll be covering is the incorrect denial of DME based on CMS MUEs, and how to address incorrect denials via SBRs and IBRs.

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