Regulations
| 9792.5.12....Independent Bill Review - Consolidation or Separation of Requests | |
| Â (3) After consultation with the Administrative Director, the IBRO may allow the consolidation of requests or independent bill review by a single provider showing a ...more | |
| 9792.5.13....Independent Bill Review - Review | |
| (a) If the request for independent bill review involves the application of the Official Medical Fee Schedule (OMFS) for the payment of medical treatment services or goods ...more | |
| 9792.5.14....Independent Bill Review - Determination | |
| (a) Within sixty (60) days of the assignment of a dispute to an independent bill reviewer under section 9792. 5. 9(g), the reviewer shall issue a written determination, ...more | |
| 9792.5.15....Independent Bill Review - Implementation of Determination and Appeal | |
| Â (c) If the final determination of the Administrative Director is reversed by the Workers' Compensation Appeals Board, the dispute shall be remanded to the ...more | |
| 9792.5.2....Standardized Medical Treatment Billing Forms/Formats, Billing Rules, Requirements for Completing and Submitting Form CMS 1500, Form CMS 1450 (or UB-04), American Dental Association Form, Version 2006, NCPDP Workers' Compensation / Property & Casualty Universal Claim Form, Payment Requirements | |
| § 9792. 5. 2. Standardized Medical Treatment Billing Forms/Formats, Billing Rules, Requirements for Completing and Submitting Form CMS 1500, Form CMS 1450 (or UB-04), ...more | |
| 9792.5.3....Medical Treatment Bill Payment Rules | |
| (a) On and after October 15, 2011, claims administrators shall conform to the payment, communication, penalty, and other provisions contained in the California ...more | |
| 9792.5.4....Second Review and Independent Bill Review - Definitions | |
| Â (e) âConsolidationâ means combining two or more requests for independent bill review together for the purpose of having the payment reductions contested in ...more | |
| 9792.5.5....Second Review of Medical Treatment Bill or Medical-Legal Bill | |
| Â (c) The request for second review shall be made as follows: Â (1) For a non-electronic medical treatment bill, the second review shall be requested on either: ...more | |
| 9792.5.6....Provider's Request for Second Bill Review - Form | |
| Provider's Request for Second Bill Review. New section filed 12-31-2012 as an emergency; operative 1-1-2013 pursuant to Government Code section 11346. 1(d) (Register ...more | |
| 9792.5.7....Requesting Independent Bill Review | |
| (a) If the provider further contests the amount of payment made by the claims administrator on a bill for medical treatment services or goods rendered on or after January ...more | |
