Our Services

We provide legal services for the managed care and health insurance industry.

Expert Exams provides, on a national basis, experienced, licensed professionals performing Independent Medical Exams and other managed care Medical Legal services.

Comprehensive Reviews are completed by certified Legal Nurse Consultants equipped with the skills and expertise to perform in-depth medical reviews and evaluations. We are available to respond to your questions and will customize our services to meet your needs.

Advantages:

  • Chronological and unbiased summaries of medical records and treatment performed by a certified LNC
  • Identify missing records, delays in care, excessive treatment, credibility issues, and matters related to standards of care
  • Compare and correlate medical treatment and documentation to allegations
  • Educate claims examiners and attorney regarding medical facts and issues
  • Provide conclusions and recommendations to aid in developing case strategy and claim reserve

Expert Exams will combine, organize, and index your paper or electronic medical records into one PDF electronic binder. All case file records will be indexed according to the type of document or service, placed into chronological order and Bates numbered.

Advantages:

  • Turns chaotic unorganized records into one organized & indexed electronic PDF file
  • Easily identify missing medical records and gaps in care
  • Saves time and money for your Staff and medical experts
  • Provides quick navigation of the medical records necessary to support the litigation process

IME’s are crucial in managing and containing cost by determining the appropriateness of past, present, and future treatment. We offer a broad network of physician medical examiners that are experienced in addressing the specific needs of the insurance and legal industry

Advantages:

  • Helps to evaluate and value claims
  • Determines if claimant is eligible for disability benefits or compensation
  • Determines if the injury or illness is related to the claim

The Peer reviewer is selected based on information provided in the allegation. The reviewer will analyze all medical records and provide a verbal and/or written report of past medical and surgical history, relatedness of symptoms to injury, causality, progress toward recovery, and provide you with recommendations for further care, if required. This is a review of records only, without a physical examination of the injured party.

Advantages:

  • Expert opinion related to care and treatment
  • Expert to review all medical records and comment on past medical and surgical history, relatedness, of symptoms to:
  • Injury
  • Causality
  • Progress toward recovery

Our bill review provides a review only of medical bills so our clients can determine the actual cost of treatment. This information is used for settlement purposes or to determine actual value of the medical portion of the claim. Our bill review experts can also provide affidavits, which can be tailored to meet each jurisdiction’s requirements.

Advantages:

  • Medical bills are reviewed to achieve optimum cost containment
  • Provides a comprehensive coding review, and bill re-pricing
  • Fraud detection
  • Usual, customary, and reasonable review

We utilize experienced, licensed, board certified Radiologists to review medical imaging, such as x-rays, MRI, and CT scans. This is a review of imaging and diagnostic reports only, no examination required.

Advantages:

  • Determine age of injury or pre-existing conditions
  • Confirm diagnosis
  • Confirm level of healing
  • Confirm image quality

Experienced professionals provide an accurate assessment of the exposure for future medical costs. Our Medical Cost Projection solutions are tailored to meet individual clients’ needs. This services features Medicare and Social Security disability verification, comprehensive MCP assessment (can be utilized on either workers’ compensation or liability claims), conditional payment investigations, and customized electronic intake workflow.

Advantages:

  • Proven reliability in clinical assessments
  • Expedited referrals completed in 5 business days; standard referrals completed in 10 business days
  • Customized, creative solutions for allocation and pricing of prescription of medications
  • Real-time reports for up-to-the-minute information
  • Availability of medical professionals to mitigate and manage excessive treatment patterns