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.