| Consulting
Our team of doctors is available to
provide expert and professional advice in areas concerning
medical and chiropractic healthcare and physical medicine.
This would include, but not be limited to,
issues involving abusive and fraudulent billing practices,
negligence and malpractice, functional assessment of injured
workers and appropriateness of assigned impairment ratings
and hands-on evaluations of claimants.
Peer Review
A peer review is the process by which an insurance claims
adjuster elects to have a case file looked at by a qualified,
licensed and trained physician. It is an integral part of
the claims adjudication process and can be of great benefit
to the claims adjuster. A peer review may address issues such
as usual, customary and reasonable charges and services, the
medical necessity for continued care and causality.
A licensed physician or chiropractor with appropriate clinical training
and experience can review a patient case file to formulate
an opinion in regards to appropriate utilization of past services
(retrospective review), present services (concurrent review)
or future services (prospective review).
Our Doctors have over 55 years of combined experience including clinical, academic
and Seminar Education.
Impairment Ratings
An Impairment Rating is performed to assess the functional
loss of a patient's physical capabilities. The rating is determined
utilizing the American Medical Association publication entitled
" Guides to the Evaluation of Permanent Impairment".
This rating will assist the insurance investigator by identifying
objective clinical findings that can place a value, in terms
of a percentage, on a patient's injury.
The Impairment Rating determination is based upon a review
of all medical records, an in-depth consultation and a comprehensive
examination of the patient. The Impairment Rating is then
calculated in accordance with the AMA "Guides" textbook.
Independent Medical/Chiropractic
Examination and Second Opinion Evaluation
An Independent Medical/Chiropractic Examination (IME) and
Second Opinion Evaluation (SOE) are "hands-on" patient
examinations given by a Doctor other than the treating Doctor.
These types of evaluations may be requested by an insurance
company, an attorney, by the patient, by the treating doctor
or by an Administrative Agency.
An IME or SOE gives an unbiased, independent, objective,
clinical opinion on the patient's condition and status. These
evaluations may address issues such as appropriateness of
care, appropriateness of additional testing procedures, ability
to return to work and medical necessity and recommendations
for future care.
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