I have delineated the 7 most vital P.I. changes in the short complimentary videos below:
Here we explain the 99204 level Examination has been replaced by a new and higher level M Code “Injury Model” Examination, designed for Personal Injury. This is a key in enhancing your core competence. It’s the first step in preventing adjusters and IME’s from disputing and denying your claim factors. It will enhance your P.I. business. It’s so highly regarded, that the Government website shows this code with a chargeable fee in excess of 500 dollars. If you aren’t using this high examination level, this is a must-see video.
Are you using the “Specific Disorder of the Spine” category? In order to get full valuation for a disc injury, you must place disc injuries in this category and reference the AMA Guide; edition, chapter, table and page to show that “the disc condition puts pressure on the thecal sac or spinal cord” – or the disc “Injury Severity Type” will be dragged down to a lesser valuation. Click to hear more.
A single phrase representing overall prognosis as: Excellent, Good, Fair, Guarded, Poor or Clinically Unstable is no longer accepted. You will learn what the prognosis must establish including the degree of reasonable medical probability (RMP) from 0% to 100% of future recurrence. An overall generic prognosis is no longer of value. There must be a specific prognosis for EACH individual injury.
The WPI carries a 25% valuation of the entire medical claim and must be included. This video will delineate an automated rating method. A Chiropractor’s WPI is not accepted in a Colossus claim without sign-off by a disinterested 3rd party. This process gives greater weight to the claim and has a code and fee for reimbursement.
In this video, Dr. Liberti explains the importance of establishing a DRE Category on the initial visit. Determining both DRE and DBI categories on the initial visit will add valuation into a Colossus claim. Find out what injuries carry greater weight according to AMA Guides.
There are 2 cervical injuries that often go overlooked. An ex All State Superintendent revealed that one of them carries a case settlement reserve of Sixty Six thousand dollars. A P.I. attorney says 45% of these injuries are missed. One injury takes 2 months to present itself. You will learn why they go overlooked and how to better diagnose them.
The introduction of “Business Process improvement” by the insurance industry established that the adjuster no longer has to accept narratives as evidence. Attorney experts report that injury findings must now be presented in a Table format to replace the narrative. Find out more in this short video.
The personal injury industry has changed. Those who know how work around or with the changes save time, have more referrals and make more money. They are enjoying increased respect within their medical-legal community, outperforming their competitors and creating a new brand that commands TOMA.