Unbiased Medical Review Support for Easy Decision Making

by | Published on Aug 18, 2012 | Medical Record Review

As a physician appointed by the insurance company you have to assist the payer to arrive at evidence based, consistent decision regarding claims settlement. The insurer depends on your review to provide enrollees rightful coverage for medically necessary treatments, and eliminate over utilization. That clearly highlights the significance of your role. It is up to you to provide an objective, unbiased expert medical opinion. The question is as a medical professional with a hectic work schedule can you complete your work on time? Delay on your part to furnish the medical review will automatically lead to a delay in settling claims.

Time Is Crucial

With increase in the number of claims, physicians often find themselves running out of time. To get the job done on time and gain relief from the complex workload, the practical way out is to obtain independent medical review services from a reputable medical record review company.

  • The independent medical review firm will make your job easy by organizing the numerous medical records relevant in a particular case.
  • Whatever your specialty may be, the medical review firm will have professionals well-versed in handling related cases.
  • Apart from medical record organization, you can ask for services such as medical case chronology and medical case history and summary.
  • The medical review support staff analyzes the records carefully, and prepares summaries highlighting the patient’s condition, patient history, all services provided and other relevant details. These concise summaries will present the case to you in an objective manner, which in turn will help you arrive at a fair decision quickly.
  • Usually medical review companies return the documents within 24 hours, which provides physicians considerable relief from frustration.

What is advantageous about tying up with such a service provider is that you get objective reports that take into consideration the medical as well as the insurance side of the healthcare information. This is significant because your independent medical review will help the payer ensure that money is not spent on unnecessary care, especially with recent statistics showing that around 30% of all medical procedures provided in the US are not medically necessary.

Discover our medical record review solutions and partner with us for your next case.

Related Posts

Best Practices for Conducting Thorough Legal Medical Record Reviews

Best Practices for Conducting Thorough Legal Medical Record Reviews

According to a John Hopkins Study, more than a quarter million deaths occur as a result of medical errors, making it the third leading cause of death in the United States, after heart disease and cancer. Regardless of whether the requirement is for malpractice cases,...

Understanding Slip and Fall Workers’ Compensation

Understanding Slip and Fall Workers’ Compensation

Slip and fall workers’ compensation benefits may be available to workers who sustain a slip and fall injury while doing a work-related task. Such injuries are among the most common workplace injuries and often entails considerable medical expenses and lost wages....

Understanding Narrative Summaries in Medical Record Review

Understanding Narrative Summaries in Medical Record Review

According to a 2023 report by the National Institutes of Health (NIH), around 80% of a patient’s healthcare information is disorganized, making it challenging for non-medical professionals to navigate the records. A well-crafted narrative summary is what makes medical...