Expert Witness Testimony on the Basis of Clinical Experience Could Pose Problems. Physicians may be called upon to provide testimony as medical records review expert witnesses in diverse cases because these reviews serve as an effective means of evaluating the history of patients and ensuring whether the right form of care is properly utilized by each physician involved.
Personal Injury Lawsuits – Calculating the Damages Award - Télécharger - 4shared. Why No-fault Auto Insurance Becomes Unaffordable – the Case of Michigan. The availability and accuracy of the injured person’s medical records for medical records review is one of the most essential aspects of any motor vehicle accident case.
Medical reports can often make or break a personal injury case. Around 12 states in the United States have No-fault car insurance laws – Florida, Hawaii, District of Columbia, Kentucky, Michigan, Massachusetts, Minnesota, New Jersey, New York, North Dakota, Pennsylvania, and Utah. In No-fault insurance, the injured person’s own automobile insurer will pay some or all medical expenses and lost earnings, regardless of who was at fault for the accident. No-fault insurance laws vary with the states; some states have a limit to the benefits the auto insurance company will pay the injured whereas in some other states there is no limit.
No-fault auto insurance can be very expensive. Most lawsuits end with a settlement by the insurance company that may want to avoid the bigger expense of continued litigation. Medical Records Review Reveals Snags in Autism Screening. ASD (autism spectrum disorder) is described as a range of complex neuro-developmental delays characterized by marked impairment in social and communicative functioning with repetitive or restrictive behaviors and interests.
Just as with other medical conditions, medical records review is important in diagnosing and treating autism and related disorders. In the United States, prevalence of ASD is estimated at 1 in 68 i.e. 14.7 per 1000 children, with a male to female ratio of approximately 4 to 1, according to the Centers for Disease Control and Prevention’s Autism Developmental Disabilities Monitoring Network (ADDMN). In most US states, the average age of diagnosis is approximately 4 to 5 years though the signs and symptoms of ASD can be detected as early as a child’s first birthday. The best prognoses for ASD are found among children with an early diagnosis and subsequent early intensive behavioural intervention, experts say. This risk of ‘false positives’ had been cited by the U.S. Decoding Employee Retirement Income Security Act (ERISA) Disability Benefits. People who have a long-term disability (LTD) insurance policy, and are unable to work could be eligible for long-term disability benefits.
The Employee Retirement Income Security Act (ERISA) is a federal law that governs most group LTD policies. ERISA was signed into law in 1974 by President Gerald Ford. As a law that pre-empted all state laws on employee benefits, ERISA created a uniform system of taxation and one body of law to throw light on the intricacies of employee benefits. ERISA is applicable only to disability insurance benefits offered by an employer as part of an employee benefits package. This means that it would not apply to private disability insurance plans that employees may buy on their own. Important Considerations There are certain eligibility requirements disabled employees must meet before the provider pays the benefits. A minimum length of serviceA minimum waiting period before the benefits startQualifies under the plan’s definition of total disability.
Hip Implant Failure and Product Liability Litigation - a Continuing Saga. In any product liability case, whether artificial hip, knee, transvaginal mesh, or faulty drug, medical record retrieval and medical records review are important processes, and the defendants will want to see the complete medical file of the injured person.
Typically the defense would ask for the entire medical history with a view to finding something that could be of use to them. A recent lawsuit associated with Stryker LFIT V40 femoral head is a significant one.
MOSmedicalrecordreview. Health Insurers Charged under the False Claims Act - a Serious Concern. Medical claims review is an important step when reimbursing for medical services to ensure that provider billings are accurate and that the appropriate services are provided to the patient.
Insurers utilize this service to determine patient eligibility and other details and it is expected that these carriers will focus on providing fair reimbursement for the medical services the patient uses. It is a matter of great concern when health insurers fall under the shadow of doubt with allegations against them of extorting taxpayers’ money. On May 16th the federal government sued UnitedHealth Group alleging that this healthcare company wrongly received at least $1 billion in “risk adjustment” payments based on inaccurate data submissions.
The Feds questioned the “one-sided” chart reviews that focused on maximizing taxpayer dollars to the nation’s largest health insurer, but did not correct the errors that supposedly increased the company’s revenue. Why Communication is Essential to Manage Workers Anxiety and Workers Comp Costs. With the constantly rising workers’ compensation costs, employers and their insurers are always considering ways to reduce the costs and any fraud associated with the workers’ comp program.
This has made the independent medical examination (IME) and its integral medical records review process all the more significant. The IME helps the insurer better able to make fair decisions regarding how to handle the claim. It provides the necessary information as regards whether to continue/discontinue/change the medical treatment, and also to determine the appropriate permanent partial disability benefit or the permanent total disability benefit. Subrogation - an Important Consideration in Workers' Compensation Insurance. Insurance terminology and processes may be intriguing to people outside the industry, but as providers of medical record review services for attorneys and the insurance sector we strive to stay informed regarding these.
Among the various terms, “subrogation” in connection with workers’ comp insurance is one that has to be clearly understood. Most auto, commercial, liability, property, and workers’ compensation policies contain a clause that addresses subrogation. To explain in simple terms, if Party A accidentally injures Party B, and the latter is compensated for the injury by Party C, C has the right to seek recovery for the amount of its payment to Party B by suing Party A. Though subrogation clauses may slightly vary from one type of policy to another, they all have the same general intention. What are the types of claims that could be caused by a third party? Medical Record Keeping as an Art – Improving Accuracy and Reliability. Any mundane activity can be made more interesting if it can be artistically done.
That is to say, a creative spark added to a routine activity breeds a new interest in it while also bringing about better outcomes. This is something that applies to even a process such as medical record keeping. In the course of providing medical records review, we have come across artistically and systematically maintained documents as well as many disorganized and confusing sets. Needless to say, the former are a pleasure to deal with while the latter make the entire review process a real battle. A Case of “Casebooks” and ArtistrySpeaking of artistry in medical record keeping, the recent Casebooks exhibition in London held in March – April 2017 was a thrilling experience to many. Six artists who were invited by the curators to take inspiration from Forman and Napier’s curious practice of charting showcased their artworks in the exhibition.
Social Security Program Needs Reform to Achieve Its Objectives. Social security disability benefits that are granted after a stringent medical records review are a lifeline for many disabled Americans.
However, now many workers are considering the pros and cons of applying for SSDI. The growing costs of SSDI – around $143 billion in 2015, along with billions for Medicare, which SSDI recipients receive – and the reasons for the rising costs have been much discussed and debated. There are official forecasts showing that the disability portion of the SS Trust Fund will be exhausted by the year 2022. Observers believe that the Social Security disability program needs reform, especially from the point of view of the fact that the country’s long-term economic potential depends on making sure that work pays for all people who are willing to work. The disability program rules require that applicants must be totally unable to engage in any substantial gainful activity. See Who Is Accessing Your Medical Records with Google’s Security Tool. Medical record review companies handling sensitive medical records have one thing uppermost in mind, namely, maintaining the security and confidentiality of the healthcare information passing through their hands.
These documents have to be securely stored and maintained, and only authorized personnel allowed access to them. This is an indispensable requirement in all facilities where medical records are kept. HIPAA requires healthcare providers as well as their outsourcing partners to maintain the confidentiality of patient records. Employee Wellness Programs and the Legal Issues Involved. Opioid Overdose Epidemic—a Major Concern in the Workers’ Compensation System. When it comes to fair claims settlement by an insurance company, medical peer review is a very significant process. This helps determine whether the treatments provided to the patient were medically necessary, and whether the claim is a legitimate one.
In many cases, a reliable peer review helps insurers avoid paying huge dollar amounts to undeserving people. A Case of Employee Conduct Creating an “Intervening” Cause of Death. How Health Insurers Can Improve HEDIS Quality Measure Performance. HEDIS or Healthcare Effectiveness Data and Information Set is a widely used group of measures that enumerate quality performance among providers and health payers in any given year. HEDIS quality measures are created and defined by the NCQA or the National Committee for Quality Assurance. Some of these quality measures are cancer screenings, flu shots, childhood immunization status, heart attack treatment, high blood pressure treatment, and asthma medication management. HEDIS medical record review is one of the ways in which NCQA collects HEDIS data. Other methods include surveys, and health insurance claims.
Workers’ Compensation and Drug Testing – Facts to be Aware of. Medical records review is an important process in a workers’ compensation claim, and the medical record retrieval process can be quite challenging. The record review is the basis on which the merit of the case is determined. Often, employers/contractors may require to test their employees on a specific project for the presence of drugs and alcohol. In some cases, the employee may be within his/her rights and under doctor’s orders to take certain prescription drugs or medications. In workers’ comp cases, drug use can become a particularly controversial topic.
Employers and insurance carriers are particularly careful that the benefits they pay injured workers do not go towards supporting an illegal drug habit they may have. A positive test cannot be considered a basis for disciplinary action against an employee without the employer first preparing a written policy. Injured employees may be prescribed a medication that may return a positive drug test result. Uncertainty Posed by New Medicare Set-asides for Liability Claims. Medical records analysis is an important process in personal injury and workers’ compensation claims to determine the nature of the injury, its extent and to determine the right course of treatment. Usually, employees have no difficulty in getting their workers’ compensation claims sanctioned. However, sometimes employers may contest the claim or the claim may be contested within the employee’s state’s workers’ compensation process.
When such a workers’ compensation or personal injury liability case is settled, the amount of the settlement that is set aside for medical care must be put into a special account called a Medicare Set-aside Account or MSA Account. Once the claimant spends all of the money in his/her MSA Account, Medicare will begin paying bills for the claimant’s injury provided all the funds are spent properly and all the rules for reporting and record keeping are followed.
Prescription Opioids a Real Crisis in Workers' Compensation. In-house Versus Outsourcing Medical Record Retrieval. Medical Records Vital for Claiming Disability for Back Pain. The Social Security Administration receives many disability applications for back pain which is a major health concern for many Americans after 40 or 50 years of age. As in any other disability claim, medical records review is an important first step in this case as well. To be eligible for disability benefits, the claimant must have a “medically determinable” back impairment such as spinal stenosis, herniated disc that is chronic and untreatable, arachnoiditis, or nerve root compression. Global Asbestos Awareness Week to Highlight Asbestos Related Risks. Disability Claims Approval Tougher without Treating Physician Rule.
Disability benefit applicants as well as those receiving the benefits need to stay abreast with Social Security updates that appear from time to time. Getting Back to Work While Receiving SSDI and SSI Benefits. Improving Healthcare Outcomes with Active Patient Engagement. Workers’ Compensation Program. Www.mosmedicalrecordreview.com (800) 670 2809. Eggshell Plaintiff Rule Beneficial in Personal Injury Cases. A person injured due to the negligence of another party can file a personal injury lawsuit and seek compensation through the court. Kentucky Workers’ Compensation Update Favoring Businesses and Insurers. New Rule Beneficial for Veterans Exposed to Polluted Lejeune Water. 3 Scenarios Where You Can Lose Social Security Disability Benefits. Apology Laws May Not Reduce Medical Malpractice Claims After All. CA Succeeding in Reducing Provider Fraud and Lien Abuse. How to Reduce Professional Liability Associated with Patient Portals.
How Sensible Is It to Replace Court Reporters with Audio Recording Devices? How to Mitigate the Risk Associated with Product Liability Claims. Protecting the Social Security Program Is Vital for the Wellbeing of Seniors. Medication Misuse Risky for Patients in Nursing Homes. Understanding the Concept of Non-subscribers in Connection with Workers’ Compensation Insurance. Data Privacy Top the List of Healthcare General Counsel’s Concerns. Getting SSDI Benefits after Age 60 Could Be Easy and More Beneficial. How to Keep Your Personal Data Safe from Hackers in 2017. Earned income tax credit – people with disabilities may qualify.
TN Court Says Benefit Limit for Undocumented Workers Unconstitutional. Medical Liability Defense - Important Factors to Consider. Recording Surgeries and Its Implication in Medical Malpractice Litigation. Medical Records Security More Important than even Credit Card Data. Reviewing Medical Records for Anesthesia Errors. Disability Reviews Having a Vicious Impact in the UK. Jury Grants a Sizeable $1.4 Million to Auto Accident Victim. Medical Identity Theft and Its Serious Offshoots. Rules Toughened for Social Security Claiming Strategies. Medical Case Review in Medical Malpractice Defense. How to Maximize Medical Case Summaries. Seven-mistakes-to-avoid-when-applying-for-social-security-disabi. No COLA Increase in 2016 for Social Security Beneficiaries. Social Security Insurance Programs – Some Facts to Know. Maintain and Update Medical Records. How a Record Retrieval Service Can Support Legal Entities.
Do You Know These Key Facts about Social Security? Applying for Disability Benefits for a Multiple Sclerosis Patient. Peer Review Key for Workers' Compensation Claims. Ensuring Legality of Electronic Medical Records through Audit Trail. Inadvertent though Serious Breach of Electronic Protected Health Information (ePHI) by MOS Medical Reviews. Medical Records Disclosure - a Continuing Threat.
Record Review Detects Faulty Remote Prescribing. Tampering with Medical Records Can Make a Medical Malpractice Case Indefensible. New Reforms recommended to Curb Diagnostic Errors. Case Evaluation and Medical Evidence Analysis in Product Liability Li… Medical records – Game Changers in Doping Cases. Medical Record Review - Maintain Record Standards. Request and Review of Medical Records by Paralegals.
Shocking Statistics of Medical Errors in America – the Need for More Effective Review and Preventive Measures. Use of Medical Records in Personal Injury Claims. Identifying Medical Record Components - Medical Record Review Process. Medical Records Review for Healthcare Providers. HEDIS-QARR Medical Record Review and Clinical Data Collection. Physician Peer Review. Medical Records Analysis. Medical Record Organization. Emergency Room Medical Record Review – Vital in Personal Injury Claim Settlement.
Emergency Room Medical Record Review – Vital in Personal Injury Claim Settlement. Emergency Room Medical Record Review – Vital in Personal Injury Claim Settlement. Medical Record Review Transcription. Medical Record Review Transcription. Smartphones to Bridge Gaps in EHR Systems. MOS Offers Free Trial for its Medical Record Review Services. Food Stamp Cut and Its Impact on SSD Beneficiaries in the US. Maintaining Data Security. Obtaining Medical Records for Legal Requirements. Medical Record Review Outsourcing. MOS Expanding Its Team to Handle Large Volume Medical Record Review Requests.
MOS Expanding Its Team to Handle Large Volume Medical Record Review Requests. COLA Increase for Social Security Beneficiaries in 2014. Would Use of Technology Lead to More Medical Record Errors. MOS Offers Free Trial for its Medical Record Review Services. Medical Chart Review for Social Security Disability Firms. The Looming Threat of Fake Health Insurance Claims in the US. The Looming Threat of Fake Health Insurance Claims in the US. The Looming Threat of Fake Health Insurance Claims in the US.