Treatment class · subcategory · California
Electric Wheelchair denials at external review
When a California health plan denied care in the electric wheelchair class and the enrollee took it to Independent Medical Review, this is what independent physician reviewers decided.
20.0%
- Overturned
- 6 of 30
- Era
- 2021-2025
- Jurisdiction
- California DMHC IMR
- Published class
- Electric Wheelchair
- Median days to decision
- 51
- All years
- 23.1% of 160
What stands out here
computed from this classamong the lowest
At 20.0%, this is the 3rd-lowest overturn rate of the 70 treatment classes carrying one — one of the few where reviewers more often agreed with the plan than not.
By condition
computed- Overturned — the reviewer did not sustain the denial
- Upheld — the reviewer sustained the denial
- CNS & neuromuscular—10
- Orthopedic & musculoskeletal—10
- Cardiac & circulatory—3
- Genetic disease—3
- Endocrine & metabolic—2
- Autism spectrum—1
- Trauma & injuries—1
The specific conditions inside this class
below n=30, no rate is claimed- Other—6
- Paralysis—6
- Amputation—3
- Back Pain—2
- Cerebral Palsy—2
- Diabetes—2
- Arrhythmia/Irregular Heart Rhythm—1
- Autistic Disorder—1
Every figure on this page is conditional on a denial having reached external review. Fewer than 1% of denials are appealed internally at all, so this describes denials that were fought to the end — not denials in general — and it describes California only. Who this does not cover.
Free help, first: the California DMHC Help Center files your Independent Medical Review at no cost — 1-888-466-2219, dmhc.ca.gov.