The Easy Clean PI Report: Part 10
10. Prognosis is the payoff
What should insurance pay for an injury? The Prognosis is the 2nd
most important portion of your PI report.
It tells us the outcome of EACH injury at the time of discharge.
Generally, not every injury is resolved 100%.
We prefer to know the DEGREE of resolution.
For example:
 | 307.81 Tension Headache = 90% resolved |
| 780.50 Insomnia = Resolved |
| 720.1 C2 – C4 Spinal Enthesopathy =
80 % resolved. |
By “measuring” the degree of recovery helps the attorney argue
the ‘length” of pain and suffering, enhancing the award.
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Let’s
Talk : 3rd Teleconference
Thursday, May 10th at 1:00 pm
Come and join the only “live” PI discussion in California . We
talk for only 30 minutes. We don’t charge.
Email us ANY PI questions and we will put them on the agenda. You
will be able to ask your question personally on the conference
call. To RSVP for the next teleconference please e-mail
JohnTawlian@Shawnsteel.com. Please note that there are
limited spaces, so be sure to register quickly. |
What to do with the walk in adjuster?
Once in a while an adjuster might just walk into
your clinic demanding an inspection, tour and to look at your
patient files.
Dr. Y asked what he should do if this happens to him again.
Here are the rules:
| No adjuster can walk into your clinic and demand anything
without an appointment. |
| Your office is private property. You are busy helping
injured patients. You don’t need any surprises. |
| Some adjusters can be rude and disruptive, they should be
asked to leave. |
| It’s up to you to grant the courtesy of a tour. Generally,
it’s a good idea. If you are busy, schedule an appointment.
|
| But, it certainly is against the law for anyone, including
adjusters to peruse your medical files without a HIPAA
complaint authorization. |
Some adjusters are curious to see if your clinic is credible
and active. Other adjusters merely want to intimidate. Use your
best judgment.
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New book by Lawrence Nordhoff DC
Human Subject Crash Testing [SAE International 2007]
Insights from over 50 years of frontal =, side, and rear-end
crash tests.
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Special Note: Dr Crist’s case was
discussed in an earlier PI Email Alert. Good news.
“I used your 72 hour demand letter last Thursday, Today I
received a check in the full amount due! It really worked!!!
Robin Crist DC |
.
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