Medical Legal Review

How can you be sure that the specific medical care recommended for an injured worker is appropriate and necessary?

Every injured worker’s needs are unique and you need help to review each service and ensure they are supported by established evidence-based criteria… The Service can include but not limited to diagnostic tests, treatment, medication, procedure, therapy, etc.

The Company assists with medical document review, medical data management, and medical reporting needs using a service model that integrates record review outsourcing expertise, SLAs, prompt and attentive management, all to yield efficiency and cost savings.

You get the scale to meet surges and needs and you get dedicated high caliber, qualified staff who are permanent employees accessible through the life cycle of the project.

Services span multiple disciplines including outsourced tasks, document review, medical file review, case report preparation, medical data abstraction, medical chronology production, medical surveillance, and data management. The team is truly up to the task and is committed to deliver high quality work products consistently in order for our clients to succeed.

You get to reduce review costs by as much as 50% and get the benefit of a permanent workforce. You get to conveniently communicate with our team through phone calls and video calls coordinated by your single point of contact for seamless approach for delivering the services.

For more information about how Rapid MedReview can assist with your offshore review needs, please contact us.

Peer Review Process

  • Thorough review of patient specific records
  • Consider national clinical guidelines, Health benefit plan language, and peer-reviewed literature
  • Prepare detailed report of the review findings
  • Report submission completed within prescribed time frames [can accommodate RUSH orders] »
  • Costs are typically on a per case basis, but could be provided on a project or hourly basis

You get substantial cost savings and volume discounts are available

Review Services

  • Auto / Workers Compensation /
  • Disability / Quality of Care
  • Review Report Format

The reports are formatted to the layout and design as outlined by our clients and include but are not limited to

  • Chart reviews
  • Claims history and Case reviews
  • Medical records chronology
  • Coding reviews
  • Independent medical reviews
  • Peer reviews
  • Complete medical records reviews

Benefit coverage issues

  • Claimant ID
  • Date of Accident / Work related injury
  • Service/Date of Service under review
  • Comprehensive Medical Records chronology
  • Medical History Summary of the case
  • Discussion of the treatment rendered under review
  • Clear decision
  • Peer reviews

Detailed rationale to address questions posed

The workflow has a number of review parameters applied to each review. In general, they include:

  • Review for record legibility
  • Review and document presenting problems, relevant social, family, past medical history and conditions affecting patient’s medical and injured status
  • Documentation of existence or absence of special status situations
  • Review and document previous treatments, previous treatment dates, interventions and responses, clinical data, results of tests and consultation reports
  • Review and document clinical status evaluation
  • Review and document history of medical condition relevant to presenting problem and for which there is documentation of the condition, treatment and medications
  • Review and document last use, amount use, usage patterns, treatment history or substances [includes cigarettes, alcohol, illicit, over the counter and prescribed medication]
  • Review and document presenting problems, assessment data, treatment plan, measurable goals, and document changes to treatment plan

Review and document if patient is able to conduct activities of daily living

  • Review and document referrals to diagnostic tests, therapy, stress management, relapse prevention, and pain management, etc.
  • Review and document progress note on each relevant visit that coordinates medical care to presenting problem
  • Review and document whether or not the patient has any allergies or adverse reactions to medications
  • Review and document change in medication including dosage
  • For children, review and document development history including physical, psychological, social, intellectual, substance abuse….
  • Review and document directives and procedures performed
  • Review and document depression, alcohol, and substance abuse
  • Review and document any medical condition which is complicating or contributing to the present problem medically