Filing an Independent Bill Review (IBR)
Step 1 — Confirm you've completed exactly one Second Review
IBR is the second and final step in the dispute ladder — it is only available after one SBR on the same EOR. Open the disputed bill: if the Second Review was denied or upheld, the bill detail shows the SBR-1 on file and a File IBR ($180) action. Don't file IBR for a medical-necessity denial (that's IMR/IBMR) or for anything that never went through Second Review — Maximus will reject it on procedure.
Step 2 — Generate the DWC IBR-1 application
Open the IBR Application generator (/wizard/ibr-application). It pre-fills Form IBR-1 from the bill: applicant (billing provider) identity, the bill number and service date, and the billed / allowed / disputed amounts. The left panel captures the dispute details; the right panel renders the actual application preview you'll file. Mindbill assembles it under the governing rule, CCR §9792.5(c).
Step 3 — Read the 30-day timeliness badge and pay the $180 fee
IBR must be filed within 30 days of the Second Review determination. The generator computes that window from the Second Review denial date you enter and shows an advisory badge — ✓ Timely (within 30 days) or ✗ Past 30-day deadline — so you can see at a glance whether you're still inside the window. The badge is informational, not a hard gate: it won't block you from filing, so it's on you to watch the date. The $180 filing fee is required, and it is recovered from the claims administrator when Maximus rules in your favor.
Step 4 — File with the Maximus citation attached
The IBR-1 preview lays out the full grounds for the dispute. For a PPO/MPN reduction it cites CCR §9789.30(d), the controlling rule that bars PPO/MPN discounts on medical-legal bills — consistent with Maximus IBR determinations that have overturned identical reductions. Review the rendered application, export the PDF, and file. Mindbill records the submission on the bill history and tracks the determination back to the bill.
