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Attorneys Say Maximus Not Listing Medical Records in IMR Letters
10/23/2015
the medical records reviewed and the physicians who wrote those reports.
One page of an IMR letter provided to WorkCompCentral by Diane Worley director of policy implementation for the California Applicants' Attorneys Association lists the application for IMR the utilization review determination
Category: News
3rd DCA to Weigh In on Validity of Untimely IMR Decisions
10/09/2015
130 days at one point last year the Division of Workers' Compensation reported. As of March of this year however the DWC claimed the average turnaround time had dropped to about 24 days.
" IMR decisions are being issued within 10 days from receipt of complete medical records" at the moment
Category: News
Actuaries Make Case for 2016 Rate Reduction
09/23/2015
to CAAA said he thinks a lot of the increased loss-adjustment expenses are the result of widespread inefficiencies by insurance carriers. He said there are thousands of IMR decisions in which the IMR reviewer never received medical records but nonetheless upheld a UR denial.
He also said he
Category: News
No Let Up with IMR Volume in 1st Quarter
06/22/2015
analysis of IMR decisions from the first three months of 2015 for the first of a series of quarterly updates on the administrative process created by Senate Bill 863 to resolve disputes over medical treatment requests. Based on data from the first quarter Maximus is on pace to issue about as many IMR
Category: News
CHSWC Forms Group to Study Mandatory Electronic Submission, address "Shocking" Inefficiency
06/05/2015
incomplete medical records.
For the longer term Overpeck talked about the possibility of setting up a centralized system to handle the records required to receive an IMR determination. Currently its up to several people to submit documentation such as the utilization review determination and the request
Category: News
Commenters Say proposed Home Health Care Fee Schedule Exceeds Statutory Authority
05/22/2015
the treating physician certifies the worker faces an imminent and serious threat the injured worker can request the IMR case be expedited. The claims handler has 24 hours to provide medical records to Maximus Federal Services and Maximus has three days from the date it receives the supporting
Category: News
WCAB Panel Says untimely IMR Decisions Are still Valid
05/15/2015
"meaningful timelines to engage in medical review" he warned " IMR will never have a chance to realize the cost savings expected when SB 863 was enacted."
De la Torre said he saw Tuesday's decision as "another nail in the coffin of any chance of an effective IMR program as the law is currently constituted
Category: News
Regulators Mulling Electronic Submission of Medical Records to Speed Up IMR
03/27/2015
subject. WorkCompCentral reported earlier this month that 6743 IMR cases were missing medical records past the 15-day time limit for administrators to submit the documents. The records had been missing for 90 days or more in the majority of those cases.
DWC spokesperson Peter Melton has told
Category: News
Senate Hearing Highlights wide Rift in Reforms Assessment
03/26/2015
.
Furthermore while the administration is reporting that IMR decisions are being sent to injured workers within 30 days de la Torre said that figure comes with the caveat The time is measured from when Maximus Federal Services receives medical records for the case.
De la Torre cited a WorkCompCentral
Category: News
DWC Asks Parties to Contact Maximus if IMRs Take more than 45 Days
03/20/2015
maximus.com.
However the division has confirmed to WorkCompCentral that medical records are more than 90 days late in at least 4900 cases. Department spokesperson Peter Melton said most of those cases are closed because the treatments were authorized the cases were settled the IMR was moot because of
Category: News
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