Independent Bill Review (IBR)
Legal basis: LC §4603.6
Definition
A dispute resolution process for medical billing disagreements between a provider and claims administrator when the provider contests the amount paid for medical treatment services. IBR is conducted by an independent reviewer who determines the correct payment amount under the Official Medical Fee Schedule.
Related Terms
Frequently Asked Questions
What is a Independent Bill Review (IBR)?
A dispute resolution process for medical billing disagreements between a provider and claims administrator when the provider contests the amount paid for medical treatment services. IBR is conducted by an independent reviewer who determines the correct payment amount under the Official Medical Fee Schedule.
What is the legal basis for IBR in California workers' compensation?
Independent Bill Review is governed by LC §4603.6 under California workers' compensation law. This statute defines the requirements, procedures, and standards for independent bill review in the workers' compensation system as of 2026.
What role does independent bill review play in workers' compensation administration?
Independent Bill Review is part of the administrative framework of California's workers' compensation system. It helps ensure that claims are processed efficiently and that all parties meet their obligations under the law.