IBR Decisions
Feb 28, 2024
CA Med-Legal MDs: Don't Accept Denials or Adjustments - IBR Works!
California Medical-Legal physician evaluators, Independent Bill Review (IBR) is your friend.According to data from the Division of Workers’ Compensation (DWC), 96% of ...
Mar 24, 2021
IBR Hall of Shame: Employers
Employers Holdings set a shameful new standard of indifference with regard to promptly and correctly reimbursing providers. The insurer incorrectly denied payment, disregarde...
Nov 18, 2019
Victory for Providers: Maximus Rules on CPT 99358
*Update: The 2021 OMFS updates drastically changed how E/M codes are billed. The article below only applies to DOS before March 1, 2021.*In the past, DaisyBill has rep...
Nov 4, 2019
Convoluted Coding: Applied Underwriters Tries to Shortchange Provider
For anyone concerned by the lack of providers willing to treat injured workers, the following dark tale perfectly illustrates the reason so many providers flee workers’ comp....
Sep 6, 2019
IBR Stats Show Why Fighting Incorrect Reimbursement Is Worth It
In California, it can be entirely too difficult for providers to collect proper reimbursement for treating injured workers. Among the many reasons for this unfortunate realit...
Feb 19, 2019
IBR Appeal Analysis for CPTs 99358 & 99359
**Update: The 2021 OMFS updates drastically changed how E/M codes are billed.*Reimbursements for CPTs 99358 & 99359 are tricky because payers frequently deny reimburse...
Feb 12, 2019
Maximus Confirms Using Second Review Appeals to Correct Billing Errors
Correcting a coding error is as simple as submitting a Second Review appeal explaining the error. Last year, we discussed the convoluted process to correct billing err...
Sep 20, 2018
Maximus Blunders AGAIN with 99358 Decision and a Math Error
Maximus Federal Services, the entity responsible for conducting Independent Bill Review (IBR) on behalf of California’s Division of Workers’ Compensation (DWC), has once agai...
Sep 14, 2017
IBR Injustice: Maximus Mishandling 0232T Decisions
A client of DaisyBill recently brought to our attention another poor Independent Bill Review (IBR) by Maximus Federal Services, the entity the California Division of Workers’...
Aug 31, 2017
Maximus Gets It Wrong in 99358 IBR Decision
Maximus Federal Services, the arbiter of Independent Bill Review (IBR) for the California Division of Workers’ Compensation (DWC), has denied payment to a provider due to an ...
May 23, 2016
🔎 Search Thousands of IBR and IMR Decisions 🔎
With two new workers’ comp tools, searching through past decisions just got a whole lot easier:DWC’s announces super-useful search tool for Independent Medical Review ...