Independent Medical Examination and the Need for Medical Record Review Services

Independent Medical Examination and the Need for Medical Record Review Services

The independent medical examiner appointed by the insurer usually utilizes medical record review services to save time and effort and arrive at a quick decision MOS Medical Record Review 8596 E. 101st Street, Suite H Tulsa, OK 74133

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In a personal injury lawsuit, the insurance company may request an independent medical examination or IME of the claimant, which would involve a detailed review of the relevant medical records prior to the examination. The independent medical examiner appointed by the insurer usually utilizes medical record review services to save time and effort and arrive at a quick decision. Why does an insurance company ask for an IME? For one thing, the insurer would want to know whether the injuries sustained are as severe as claimed by the plaintiff, or they may just be concerned about the actual extent of the injuries. Attorneys handling personal injury cases must also be cautious about accepting such cases. Through an initial medical record review, they can determine the merit of the case before taking it up.

A second opinion examination, the IME involves a complete physical exam of the claimant, and a review of all diagnostics and medical records provided, on the basis of which the medical expert gives an objective and informed opinion.

Independent Medical Examination – Standards and Requirements The standards for IMEs differ from one state to another though there are a number of general requirements. Let us look at some of these. 

Only a single IME is permitted if there is no good cause for further examination.

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The insurance company must make sure that the claimant is given reasonable notice of the time, location, manner and scope of the examination.

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The insurance company has to bear the costs of the IME.

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The independent medical examiner must be available to be cross examined by the plaintiff’s lawyer at a deposition or trial.

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Once the IME is over, the physician has to complete a report that both parties can review. The report should comprise a small introduction containing the basic details such as injury dates, and a summary of the premises arrived at. This report should also

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give a detailed description of the initial conversation between the medical examiner and the injured person. Other requirements are -- a detailed documentation of the physical examination findings, and a diagnosis.

Insurers may have definite clauses in their policies with regard to IME requirements. Typically, insurance firms request a large number of IMEs every year. In many states, the claimant who is undergoing the medical examination is allowed to bring his/her own physician to the exam.

Medical Record Review Services Have an Important Role to Play An IME report is unique and a crucial evidence in hearings and other legal proceedings. This calls for clear and precise descriptions in the report. Medical record review for independent medical examiners is a service provided by medical review companies. It involves an early evaluation of the medical case by reviewing all the medical records available. This will give the medical examiner a clear idea about the important aspects of the case that will prove useful during the exam. The service is valuable because all medical documentation will be sorted and indexed and a concise summary made available. A detailed chronology and timeline is also prepared.

Specialty physicians that are most in demand for IMEs are neurosurgeons, neurologists, orthopedicians, pain specialists, physiatrists and psychiatrists. A medical review team providing the service would comprise medical professionals including physicians and registered nurse consultants knowledgeable in the terminology, disease conditions and treatment procedures pertaining to various medical specialties. This would ensure accurate and reliable review and analysis of the medical documentation.

Apart from insurance companies and independent medical examiners, attorneys, legal nurse consultants, IME companies, claims managers and adjusters all stand to benefit from the valueadded services provided by a medical record review company.

www.mosmedicalrecordreview.com

1-800-670-2809