Independent Medical Review (IMR) Determinations, Trend

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.

Resources

Name Format Description Link
8 independent-medical-review-imr-determinations-trends.csv https://data.chhs.ca.gov/dataset/b79b3447-4c10-4ae6-84e2-1076f83bb24e/resource/3340c5d7-4054-4d03-90e0-5f44290ed095/download/independent-medical-review-imr-determinations-trends.csv
57 independent-medical-review-imr-determinations-trend-hiiiaw.zip https://data.chhs.ca.gov/dataset/b79b3447-4c10-4ae6-84e2-1076f83bb24e/resource/9ab6e381-bef2-43dd-b096-efa85d93a804/download/independent-medical-review-imr-determinations-trend-hiiiaw.zip
57 independent-medical-review-imr-determinations-trend-0_4hn8a_.zip https://data.chhs.ca.gov/dataset/b79b3447-4c10-4ae6-84e2-1076f83bb24e/resource/9ab6e381-bef2-43dd-b096-efa85d93a804/download/independent-medical-review-imr-determinations-trend-0_4hn8a_.zip
33 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. https://data.chhs.ca.gov/dataset/b79b3447-4c10-4ae6-84e2-1076f83bb24e/resource/2c5c2144-138f-4feb-b2af-a1176995e1b1/download/imrdatadictionary.pdf

Tags

  • independent-medical-review
  • california-department-of-managed-health-care
  • dmhc
  • imr
  • hmo-help-center

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