Power Point Presentation Pequonnock River Watershed Management Plan Power Point Presentation
Power Point Presentation 11
description
Transcript of Power Point Presentation 11
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Medical Evaluative Services
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Corporate Information
Incorporated in 1994
Maryland Corporation – headquarters in VA
Privately Held
Approximately 60 employees
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Menu of Services
Medical Evaluative Services
Discounted Diagnostic Services Medical Imaging Studies/ Neurodiagnostic
Studies
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Medical Evaluative Services
Independent Medical ExamsPeer ReviewsRadiological Film ReviewsCare Sentry ReviewsDeposition CoordinationMedical Cost Projections
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IME Service Process
Dedicated Service Team
Outside Account Manager Visits offices on a weekly basis or as requested
Inside Account Coordinator Dedicated staff depending on caseload
Quality Assurance Representative Dedicated staff member or members depending
on need.
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IME Service Process
Outside Account Manager Visits weekly Discusses IME issues with claims
personnel Copies and prepares files Communicates with inside staff Resolves issues of concern
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IME Service Process
Account Coordinator Schedules IME appointments Prepares and sends notification letters to
all parties Determines if claimant attended IME
Notifies referring adjuster/nurse Retrieves RTW forms/ IME reports/
addenda Maintains Med-Eval’s service standards Communicates with and updates
adjuster/nurse
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IME Service Process
Quality Assurance Representative Sorts and tabs medical records Prepares IME purpose letter
All letters are custom prepared No check blocks used
Includes proper RTW form (if applicable) Reviews IME reports Determines need for clarification/ addendum Prepares addendum letters Reviews clarifications Acts as Liaison between provider and adjuster
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Qualifications of QA Rep
Adjuster with ten to twenty years experience in workers’ comp and or liability claimsNurse with five or more years experience in workers’ comp or liability claimsDemonstrated knowledge of the statute in assigned jurisdictionsAbility to handle detailed and complex issuesCommitment to upholding Med-Eval’s standards of ethics in the delivery of IME services
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Value Added Services
Set up transportation serviceSet up translation serviceCoordinate depositionsRush appointments – special handlingIn-house medical transcriptionOther special handling Surveillance tapes Radiological films
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Service Standards
Appointment scheduled within 24 hours
Appointment date within 2 weeks unless otherwise specified
Notification letters sent within 24 hours of scheduling appointment
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Service Standards
Adjuster/ nurse notified within 24 hours of a no-show event
Medical records copy service
Final IME reports provided Within 2 to 10 business days
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“Rush” IME’s
IME clinicsPre-paid time slots with IME physiciansInternal “rush” procedures to ensure notifications are made, medical records are obtained, IME purpose letter is prepared, & IME physician has material in advanceAllows for quick IME appointmentsAffords fast turn around of RTW forms and IME reports
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IME Physician Panel
Board certified physiciansAll medical specialtiesCore geographical regions based on accountPhysicians contracted to Med-EvalCredentialed according to the standards of the National Committee on Quality Assurance (NCQA)
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Physician Credentialing Process
Contracted IME physicians must provide: Signed copy of Med-Eval’s physician
contract Completed Med-Eval application Answers to Attestation Questions Signed copy of Med-Eval’s Code of Ethics Copy of current state medical license(s) State and federal narcotics registrations Copies of board certifications Copy of medical malpractice insurance
certificate Curriculum Vitae Five-year work history
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NCQA Credentialing Standards
“Primary source” verifications performed for: Medical schools attended Residencies and internships Board certifications Five-year work history
In-depth verifications of: Medical licensure Sanctions Malpractice insurance coverage Physicians Data Bank checked for
malpractice suits
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Ethical Considerations
Contracted IME physicians must sign Med-Eval’s Code of EthicsCare is taken not to “lead” the IME physicianWe obtain clarifications or addenda as necessary to offer a quality IME report, but the integrity of the physician’s medical opinion is upheldWe do not maintain statistics on IME outcomes by physician
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Ethical Considerations
Our physicians are paid on a flat fee or hourly basis, with no incentive whatsoever dependent upon the outcome of his/her medical findingsContracted IME physicians must maintain a private medical practiceMedical records are scanned and securely stored electronically, limiting access to only those parties who need it
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Referring IME Assignments
Phone (800) 809-5687
Fax (800) 351-4193
Email [email protected]
Electronic Transmittal www.med-eval.com
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Referral Process
One step referral Phone, fax, email, or
www.med-eval.com
Med-Eval does the rest Contacts claimant Schedules and confirms appointment Faxes or emails results to you
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We look forward to working with you!