Datasets / Independent Medical Review (IMR) Determinations, Trend

Independent Medical Review (IMR) Determinations, Trend

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Published By U.S. Department of Health & Human Services

Issued over 9 years ago

US
beta

Summary

Type of release
a one-off release of a set of related datasets

Data Licence
Not Applicable

Content Licence
Creative Commons CCZero

Verification
automatically awarded

Description

This data is from the California Department of Managed Health Care (DMHC). It contains all decisions from Independent Medical Reviews (IMR) administered by the DMHC since January 1, 2001. An IMR is an independent review of a denied, delayed, or modified health care service that the health plan has determined to be not medically necessary, experimental/investigational or non-emergent/urgent. If the IMR is decided in an enrollees favor, the health plan must authorize the service or treatment requested.

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