Is this a lien issue, an IMR or IBR issue? (California)

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Is this a lien issue, an IMR or IBR issue? (California)

Postby earthwake@aol.com on Wed May 29, 2013 1:23 pm

I'm still trying to get how this whole IMR/IBR flow works. Our PTP sent a UR request on a RFA form asking for authorization to write her P&S report in excess of 6 pages because of the very large amount of records reviewed, and for other specific reasons. As you know, ordinarily the 99080 report only pays 6 pages. Her report ran about 27 pages.

UR either does not respond, or responds with a "no". Bill review of course pays 6 pages only.

What is the proper response? a) file a lien b) appeal the UR decision through IMR--making the case for why the additional pages are needed or c) appeal the Bill Review decision through Request for 2nd Bill Review and IBR?

This is one of many frustrating situations in which we honestly don't know the proper venue now for responding/appealing. Any thoughts?
earthwake@aol.com Posts: 15Joined: Fri Oct 30, 2009 10:30 am


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Re: Is this a lien issue, or IBR or IMR issue? (California)
earthwake@aol.com
 
Posts: 18
Joined: Fri Oct 30, 2009 8:30 am

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