Medical Case Review
Having a neutral third party experienced in medical case review and comfortable with sorting through medical records can be helpful for patients and medical providers. For example, when reviewing a medical case I can
- Provide an independent evaluation of the strengths and weaknesses of a potential malpractice case.
- Help create themes in a case and lines of questioning for medical providers or experts.
- Help providers respond to medical board or hospital queries about case management.
- Help patients dispute excessive and inappropriate or excessive hospital bills. HINT: Want a good site to find reasonable charges for medical procedures? Try MD Save.
I have helped many physicians prepare for depositions and trial testimony in medical malpractice cases, showing them the types of questions that will likely be asked and how to emphasize the strengths of the care that they have provided.
I can also serve as a personal counsel to represent a client’s interests when dealing with insurance companies.
Case Example 1: Representing a Physician Against A Malpractice Insurance Company
A physician was being told by her medical malpractice insurer that she would be required to settle a case and be reported to the National Practitioner Databank for actions she took several years earlier as a resident in the emergency department.
After several discussions with the defense attorneys and the insurer in the case, the plaintiff attorney and the insurance carrier agreed to drop the physician from the case without any liability or NPDB report.
Case Example 2: Representing a Patient Against A Hospital And Insurance Company
A patient required infusion therapy for a medical condition. She was preapproved for the infusion by Highmark Blue Shield.
After she had received two doses of the infusion, the hospital billed her for $77,442.00. Insurance paid only $2,562 of the bill.
The patient called Highmark Blue Shield several times and provided them with copies of the faxed preapproval letter. Highmark Blue Shield stated that they had changed coverage and were no longer covering infusion therapy. The patient tried to resolve the matter with the hospital and was repeatedly told her that the issue was between the patient and her insurance company. The hospital then threatened to send the patient to collections and sue her.
I contacted the hospital and Highmark Blue Cross. When they did not respond, I contacted the Illinois Attorney General and the State Department of Insurance on behalf of my client. One week later, the patient’s bill was paid in full.
Need help with a medical case review or having difficulty dealing with medical billing? Contact me. I’d be happy to try to help.