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Medical Review Services

Encore Unlimited's Medical Review Services provide useful tools to enhance our customer’s ability to impact the outcome of their workers’ compensation, auto liability, personal injury, short-term and long-term disability cases. Our specially trained and certified staff analyze medical reports, develop timelines and provide detailed recommendations to assist our customers with the critical decisions necessary to move a case forward.

Our Medical Review Services include:

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Provider Review

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Chiropractic Review

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Liability Review (Auto & General Liability)

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Legal Nurse Consulting

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Life Care Planning

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Medical Cost Projections

Provider or Chiropractic Review
Encore Unlimited provides physician and chiropractic review services that include: determination of causal relationship; peer review to assess frequency and duration of treatment; contact by a medical provider to resolve case issues; provider record review to render an opinion on specific concerns; or as an alternative or prelude to an Independent Medical Examination.

Liability Review (Auto & General Liability)
Encore Unlimited’s liability review services provide an accurate and objective evaluation of medical records for use in the negotiation and settlement of liability files (Bodily Injury, Med Pay, PIP, or General Liability). This service is designed to highlight discrepancies in file material and provide recommendations for subsequent negotiations. Encore Unlimited can help by examining the objective medical evidence that reportedly substantiates the claim, and offering suggestions as to the next step in settling, evaluating, or litigating a claim. We can also provide research on medical topics and conditions.

Legal Nurse Consulting
Our staff of specially trained and certified nurse case managers can save both time and money by providing valuable information for high dollar cases. Legal nurses assist insurance carriers and attorneys, by sorting out complex medical issues and offering solid recommendations. Our service includes testimony as well as medical record reviews, report preparation and life care planning.

Life Care Planning
This evaluation focuses on the psychosocial, physical, vocational, emotional, and financial aspects of a catastrophic illness or injury. Life care planning is an effective means to realistically control present and future services, costs, and frequency of treatment. Encore Unlimited’s life care plans are completed by a Certified Nurse Life Care Planner who is available to defend their analyses in court and provide a comprehensive outline that projects the cost of care over an individual’s life expectancy.

Medical Cost Projections
This service provides pricing for medical care needed during a specific time period. For workers’ compensation settlements, we can also assist in providing the required documentation for Medicare Workers’ Compensation Set-Aside Arrangements (WCSAA). When a catastrophic or significant injury occurs, we can assist in establishing the medical reserve needed to cover the exposure at the onset of the claim, and provide assistance in re-evaluating the medical exposure as the claim progresses.

When should you consider Encore Unlimited's Medical Review Services?

  • When the relationship of the injury to the accident is unclear.

  • In lieu of or prior to an Independent Medical Examination (IME).

  • When multiple medical conditions exist, treatment is unusual or excessive, numerous providers are involved, or pre-existing conditions are suspected.

  • When non-medical issues appear to be complicating recovery.

  • When medical treatment does not correlate with the accident, injury or disability facts.

  • When the treating provider has failed to provide clarification, despite several requests.

 


 

 

   
Copyright 2003 Encore Unlimited, LLC