IBR - Independent Bill Review

Independent Bill Review

Medical treatment and medical-legal billing disputes are resolved through an independent bill review (IBR) process. A medical provider who disagrees with the amount paid by a claims administrator on a properly documented bill may apply for IBR. They may request IBR within 30 days after service of the second review decision.

• If the Bill submitted through SBR is denied or not paid fully, the IBR would be enabled. If the bill is submitted manually, then the payment response has to be manually added for the IBR to enable. An example is given below. 

• Let's consider this Second Bill Submission is denied. 

• This will enable the Independent Bill Review tab. 

• Scroll down to go to Independent Bill Review - Bill Items, check the box for the line item the payment was denied and enter the details. 

• Add the necessary documentation to support the Independent Bill Review in the Report tab and click Download Bill and Report; there is no On-Demand service for IBR. Send the reports manually to the recipients. 

• Enter the payment response once received and close the bill accordingly.