Protocols® file review
The Protocols® file review service provides review, research and analysis of the medical and legal files related to a claim. This service yields a report that includes the comments and recommendations of a legal nurse consultant. This service can range from complex to simple:
Complete medical records and bill review includes a detailed review of an injured person’s medical records, payment history and bills. It provides a comprehensive report that addresses causal relationship and relatedness to a specific event; identification of any co-morbid factors; utilization; and the accuracy of billing. It includes comments regarding the delivery of reasonable, necessary and appropriate medical care.
Complete medical record review provides the same services as above, but excludes review of an individual’s payment history and bills.
Limited file review includes a file review and report that is limited to specific, identified records to determine their relatedness to the case, along with a determination of the reasonableness, necessity and appropriateness the medical care in a defined circumstance.
Medical bill review and analysis includes a file review and report that focuses on an injured person’s medical bills – to determine appropriate coding, charges, duplication of services and relatedness to a specific event.
Bill audit includes a more comprehensive evaluation (which may include an on-site review), to analyze the accuracy of charges by comparing them with actual medical records and other documentation of services. The bill audit report includes recommendations regarding disposition of any unsupported charges.
- Medicare set-aside
analysis and allocation
- Life care planning
- Medical cost projection/
medical reserving
- Medical case management
- File review
- Legal nurse consulting services
- Expert witness testimony
- Medical custodial
account administration
- MSA self-administration consultation
- Special needs trust consultation
- Training