Medical Record Reviews

Serious injury and complex medical claims can be difficult for the Claims or Legal Professional to manage, evaluate or settle, since each case presents with a unique set of diagnoses, medical and rehabilitation needs and/or obstacles to recovery. Just as the medical management effort can become issue-driven due to the rapidly changing needs and priorities in complex cases, so can the process of medically evaluating exposure and positioning for settlement become clouded by complications, setbacks and seemingly unproductive or conflicting courses of treatment.

A Nurse Medical Record Review by ANS Rehab Consulting can help bring the complex medical picture into focus and provide an insightful and reliable basis for claim evaluation, management, negotiation and settlement.

ANS Medical Record Reviews help identify medical issues and assess potential areas of exposure. Based on a thorough chronological review of records by our Certified Nurse Consultants, issues such as causality, extent of damages, and appropriateness of treatment are identified and evaluated. Gaps in treatment, duplicate or inconsistent treatment, missing documentation or other areas needing scrutiny are also identified, as are the overall medical priorities and direction of the case, potential high dollar “triggers”, and recommended strategies for effective care management, if requested.

ANS Rehab Consulting’s Medical Record Review provides the following key information to the Claims Professional or Attorney:

• Detailed summary of the medical issues, diagnoses, treatment, rehabilitation, medications, and other services utilized to date
• Review and critique of appropriateness of treatment, overall treatment plan, medical priorities and issues expected to impact the future exposure on the case
• Evaluation of causality, extent of damages and quality and appropriateness of medical documentation
• Analysis of the effectiveness of medical management strategies in the case and recommendations for improvement, if requested
• Establishment of a realistic context for facilitating appropriate care and negotiating future costs

ANS Rehab Consulting’s clients include national and regional carriers, employers and law firms who rely on our expert medical judgment to reinforce their claim decisions.  

Does your firm have a complex medical claim to manage, reserve or settle? Contact us to discuss how our Medical Record Review could prove to be a useful tool!

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