The Problem Today: Under-Developed Personal Injury Documentation

Each year there are fewer investigative doctors delivering personal injury (PI) care. Many trauma injuries and the long-term implications of those injuries are frequently overlooked by doctors. The reason is simple: they are primarily Health Insurance trained, and with health insurance reimbursements being the primary income source that most doctors rely on, out of necessity doctors take their diagnosis and treatment guidelines from these insurers.  

Because these health insurers are focused more on cost cutting efficiencies than they are in the details required for successful claims settlements and winning trial foundations, the insurers cost-cutting efficiency training tends to drive down detailed medical documentation. This non-PI insurance training then leads doctors to focus on a narrow range of ICD-10 codes to tell their patients’ injury story, and ICD-10 coding is not taught all that well in medical and chiropractic schools, especially as it relates to PI.

When you combine this minimal understanding of coding and lack of investigative injury skills, the result is missed optimal PI diagnosis; less descriptive ICD-10 trauma coding; partial injury treatment; missing impairment ratings; and lack of future medical care & costs.

Summary: You have underdeveloped injury documentation and a suppression of injury claim value.
The good news is Valley Mountain Medical can help!

The Solution: Claims Authentication

We understand the complexities of PI care in a Health Insurance driven community. We have also come to know how liability insurers use doctor’s health insurance training to minimize and deny just compensation for your clients injures and incident losses.

Our team of doctors, nurses and paralegals are specially trained to recognize the complexities of traumatic injuries and how these severe injuries can affect many body systems at once. Our medical forensic teams find personal injuries that are often misdiagnosed, overlooked, unsupported/under validated, and usually minimally coded. We frequently find overlooked impairable injuries, such as concussions and connective tissue damage.

Our services help identify these injuries for your clients and provide a roadmap for treating providers to:

  • Correct documentation errors
  • More accurately validate your client’s traumatic injuries
  • Improve the ICD-10 coding
  • Correctly develop and deploy treatment plans
  • Obtain justifiable impairment ratings
  • Deliver supported future medical care costs

We provide you with a tracking tool that identifies within the treatment records the locations of your clients injuries by page number, as well as listing missed coding or misapplied coding. There is also a condensed Medical Care Summary sheet, which lets you quickly identify injury and severity indicators.

Our Process: Powerful Case Value Tools

We have an array of powerful tools we can utilize in aiding your client’s claim for injury recovery:

Report is included with the service.
  • Gaps in Care Interviews
  • Informant Interviews
  • Non-economic Interviews
  • Peer-to-Peer Interviews with Treating Providers
    • Obtains pertinent information regarding the status & further care requirements of your client.
  • Functional Capacity Assessment Development & Support
  • Impairment Rating Report Development & Support
  • Future Medical Care Cost Services, and more.

Our Results: Increased Settlement Offers

Our services combine to elevate the complex injury severity your clients are suffering from. This corrected injury severity increases the medical reliability and consequently aids you in your clients settlement negotiations, further empowering you to obtain more just and deserving negotiation outcomes as compared to results received without using our expertise.

Our Claim Authentication services will help you build a better case to increase deserving recovery for your client’s care costs; helping them combat against financial disadvantages experienced due to their injuries.

To know more, contact us.