Hidden Costs….Millions lost $$$$$
Most physicians are not familiar on how to calculate an accurate impairment rating according to AMA Guidelines. Since this process is used as a basis for a PDR and claim settlement, it is critical that the Impairment Rating is correct. Unfortunately, eight out of ten Impairment/Disability Rating reports contain errors which increase the out-of-pocket cost of the claim for employers. This can be remedied by using Expert Medical Evaluators to address the AMA lack of complaint issues.
These Impairment Rating mistakes are costing the workers compensation industry millions of dollars in lost revenue or overpaid claim settlements.
The industry that relies on this critical medical information can no longer accept these types of Impairment Rating (IR) mistakes. These IR mistakes apply to any open claim when the AMA Guides is used as a basis for financial compensation and settlement.
In order to obtain an accurate IR report, a Certified Impairment Rating Specialist CIRS) should review the clinical documentation and calculation of an Impairment Rating. This AMA Compliant Review™ utilizes evidenced-based medicine as well as a resource library to review the medical reports of a Panel QME or AME report which contains an Impairment Rating.
Attorneys and Claims Professionals may have a surface understanding of the AMA guides, but only a physician who has been tested, can provide the critical analysis that is needed to help with case closure. By removing the burden of trying to interpret a doctor’s report the attorney and claims professional are freed up to do what they do best, negotiate and settle and use the expertise of EME as their own. The report identifies and corrects mistakes in the Impairment Rating with full references to where the mistakes were made and why the adjusted report is correct. Some AMA percentages increase (12%)but over 73% decrease.
With the correct WPI, this report ultimately offers you a negotiating tool that, prior to now, was unavailable for any claims settlement. Access to the EME physician network is guaranteed.
This report contains:
Accurate AMA Information
Detailed and comprehensive analysis
Full reference to all editions of the AMA Guides
A strong negotiating tool
Faster claim resolution
Article Courtesy Of:
Kathy Motley, WCC, WCCP