Medical Record Analysis

It’s best to learn the strength of your client’s medical records BEFORE they have completed active care. Our team will review your client’s current treating records to determine if your client’s injury severities have been properly documented and communicated, correctly coded, mechanisms of injury provided, concussion recognition performed, pre-existing conditions addressed, GAP’s in care, quality of life survey’s, prognosis development, valid treatment plans, re-exams/surveillance exams, Maximum Medical Improvement attainment, impairments, future medical costs, summary reports and amending medical records have all been properly derived and implemented. These crucial points will help you create irrefutable evidence of medical necessity for the treatments your client has received when you enter negotiations with insurers.

When we have reviewed these crucial points, we can also deliver a roadmap for the treating providers to use in amending the errors discovered in their records and to add those services which may have been missed that would validate the severity of injuries your client received.

Impairment Reports

Many injuries can result in permanent impairments, 97% of all PI injuries have them. They are routinely overlooked by insufficient trained doctors of all license types. Without an impairment declaration an important part of your client’s medical value is lost.

Our team scrutinizes all persistent symptoms, investigating the documentation and causation, and then determine if these are permanent injuries. As needed, we have tools that recommend supporting evidence of permanency and what to include as supportive medical evidence to arrive at a valid impairment rating. Our impairments are provided using accepted reporting formats that are approved by the AMA Guidelines.

Strategic Reporting Language for Medical Necessity

Our medical services team recognizes the documentation strengths and weaknesses your client’s injuries. We understand what the right family of supporting codes should be, what the treatment should look like, how the injuries your client’s experience are not being properly recorded in their medical records, life, and we help you secure more accurate input for the settlement negotiation process.

Improved Injury Severity and Symptom Discovery

The problem is not the value of the story, it’s the story teller. Most physicians, regardless of training, routinely miss the important aspect of documenting all injuries and symptoms experienced by your clients from their injury event.

We search the records for often overlooked symptoms that point to hidden injuries and missing diagnostic opportunities. We analyze the types of validation used to support the reported injuries and then offer remedial steps to improve the medical documentation through our Medical Record Analysis service described below.

Additionally having your staff trained to recognize important injury symptoms and calling PIMF in to help obtain better physician adherence to insurer accepted medical documentation, correct diagnoses and proven treatment plans, will lead to increased settlement offers.

Justifiable Demands Require Validated Injury Severity for Proper Settlement

Just when you think you have a great case, you find out that the medical providers didn’t communicate with each other, or worse they have conflicting, even negating comments on what they have documented in their reports.

I’ve worked with thousands of cases and I have seldom found a medical case where the providers worked together for the common good of the patient. Yes, sometimes they “cooperate” in theory, but they rarely corroborate and strengthen each other’s findings. They don’t do that maliciously, they just haven’t been trained on the best ways to corroborate.

Today’s medical training provides a foundation for care, but it’s built on the notion that healthcare understands how to deal with liability insurers and your client’s traumatic injury care. You’ve experienced why that is not true, but what do you do?

PI Medical Fortress’s professional medical record preparation will help you deliver stronger proper medical value for your negotiation strategy. By improving the presentation elements of injury severity documentation, impairment ratings, treatments, and future medicals by using our proven strategic pathways of medical analysis and validation tools, you can obtain the best possible settlement value for your client.

Medical Validations & Personal Injury

Personal Injury  healthcare physicians’ notes often contain challenging documentation quality and content that attorneys and insurance companies find difficult to incorporate into the settlement process, leading to difficulties in resolving the claim to everyone’s satisfaction. Insurers, patients and plaintiff attorneys know that trained, licensed health care physicians offer valuable care, yet at times the care documentation and coding may not be recognizable, to allow for a fair and reasonable settlement of claims. The validation of documentation and coding assists insurers and plaintiff attorneys in coming to a more accurate measurement of each claims value and facilitating a more satisfactory settlement of insurance claims. PI Medical Fortress validation doctors offer the solution to these difficult situations by giving you access to their specialty training in reviewing existing medical findings.

Code scouring for documented yet missing coding and treatment recommendations, hidden document details regarding MMI, ongoing treatment recommendations and future treatment options, and causal linking to the instant MVA and treatment validation help to increase the settlement value. Properly documented DUD/LOE can also offer added settlement value. PI Medical Fortress has highly skilled and experienced team members providing these services.

Our experience and insight with insurance company claims-management software and systems can provide strong support for your team’s med-legal case management.

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Medical Validation: How does it work?

Personal Injury healthcare physicians’ notes often contain challenging documentation quality and content that attorneys and insurance companies find difficult to incorporate into the settlement process, leading to difficulties in resolving the claim to everyone’s satisfaction. Insurers, patients and plaintiff attorneys know that trained, licensed health care physicians offer valuable care, yet at times the care documentation and coding may not be recognizable, disallowing the fair and reasonable settlement of claims.

The validation of medical services, documentation and coding assists insurers and plaintiff attorneys in coming to a more accurate measurement of each claims value and facilitating a more satisfactory settlement of insurance claims. PI Medical Fortress validation doctors offer the solution to these difficult situations by giving you access to their specialty training in reviewing existing medical findings. The systematic, in-depth review of the records offers a solid foundation regarding the influence that injuries have had on claimants and provides assurance that the most accurate medical story is being told as according to the documented content.

In the course of document management, many times our Medical Record Review process discovers hidden injuries and late onset injuries that can dramatically alter the outcome of your client’s claim! Missing records, negative injury history, damaging patient health history, etc. need to be revealed to you to aid in properly pursuing the claim value. Is your team keeping up with these opportunities? Most firms are maxed out with staff tasking. Adding PI Medical Fortress medical services to your team opens the many doors you need to properly increase settlement value.

Code scouring for documented yet missing coding and treatment recommendations, hidden document details regarding MMI, ongoing treatment recommendations and future treatment options, causal linking to the instant injury incident and treatment validation, documented Duties Under Duress and Loss of Enjoyment are all required input to achieve the correct settlement value. PI Medical Fortress has highly skilled and experienced team members providing these services.

Our experience and insight with insurance company claims-management software and systems can provide strong support for your team’s med-legal case management.

Call us today at 801-696-3619 for a complimentary consultation.