Treatment class · subcategory · California
Hyperbaric O2 Chamb denials at external review
When a California health plan denied care in the hyperbaric o2 chamb class and the enrollee took it to Independent Medical Review, this is what independent physician reviewers decided.
28.1%
- Overturned
- 9 of 32
- Era
- 2021-2025
- Jurisdiction
- California DMHC IMR
- Published class
- Hyperbaric O2 Chamb
- Median days to decision
- 36
- All years
- 34.2% of 73
Authorities named in this class
computed- FDA—2
A rate here is the outcome of decisions that named the authority, not the effect of naming it. Reviewers cite the standard they applied; the citation and the outcome share a cause.
By condition
computed- Overturned — the reviewer did not sustain the denial
- Upheld — the reviewer sustained the denial
- Skin—10
- Post-surgical complications—5
- Ear, nose & throat—4
- Endocrine & metabolic—3
- Cancer—2
- Orthopedic & musculoskeletal—2
- Blood disorders—1
- CNS & neuromuscular—1
The specific conditions inside this class
below n=30, no rate is claimed- Other—10
- Hearing Problem/Loss—4
- Diabetes—3
- Infection—3
- Skin Ulcer—2
- Brain Injury/Concussion—1
- Breast—1
- COVID 19—1
By review type
computed- Medical Necessity—26
- Experimental/Investigational—6
Medical-necessity review asks whether the care is needed. Experimental/investigational review asks whether it is likely to be more beneficial than standard therapy — a harder statutory test, and the rates show it.
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.