The California Division of Workers’ Compensation (DWC) published a new report on 2025 independent bill review (IBR) for 2023-2024 application filings, highlighting ongoing challenges in the accuracy of medical bill payments within workers’ comp.

The IBR process is designed to resolve billing disputes when the sole issue is the amount payable for medical services or goods provided to an injured worker. After receiving a denial or payment adjustment, a medical provider may seek reconsideration through the Second Bill Review (SBR) process. If the provider disagrees with the payment amount following a properly documented bill and SBR decision, the provider may then request IBR.

According to the report, only about 6% of medical bills challenged through the administrative dispute process were initially paid correctly. In total there were 7,853 case dispositions filed in 2023 and 2024, and 24% of those cases were deemed ineligible or withdrawn.

IBR decisions were rendered within an average of 43 to 50 days, and IBR decisions resulted in total additional payment awards of $7.7 million, with an average award of approximately $1,378 per dispute.

Interpreter services continued to be the most frequent source of billing disputes, Disputes related to physician services ranked a distant second.

Persistent billing accuracy challenges can result in payment disputes, additional reimbursement, and increased administrative and compliance exposure. The report reinforces the importance of accurate bill review as California continues to closely scrutinize payment practices and IBR outcomes.