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.