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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?
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When the
relationship of the injury to the accident is unclear.
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In lieu of or
prior to an
Independent Medical Examination (IME).
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When
multiple medical conditions exist, treatment is unusual or
excessive, numerous providers are involved, or pre-existing
conditions
are suspected.
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When
non-medical
issues appear to be complicating recovery.
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When medical
treatment does not correlate with the accident, injury or
disability
facts.
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When the treating
provider has failed to provide clarification,
despite several requests.
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