David J. Klecka 2013-03-06 00:43:54
The Independent Medical Evaluations (IME): Credentialed Professionals and Superior Results David J. Klecka is a general manager manager at ExamWorks Group, Inc. David is responsible for the operations in Arizona, Colorado, New Mexico, Nevada and Utah. Prior to becoming the general manager for the Arizona business unit he served as the regional account executive working in the Phoenix and Tucson markets. David first entered the industry as an agent for Farmers Insurance. He began his career in education where he spent 12 years dedicated to high school special education and coaching and four years as a scholastic sales representative for Jostens, Inc. He earned a B.A.E from Arizona State University and a M.A from Northern Arizona University. Serving the states of AZ, CO, NV, NM and UT. David can be reached via email at David.firstname.lastname@example.org or at 602-282-3346. The Independent Medical Evaluations (IME): Credentialed Professionals and Superior Results Choosing the best qualified professionals to assist with IMEs not only saves time and money, but also ensures that every detail is handled in accordance with the industry’s highest standards, privacy guidelines and regulatory requirements. IME service professionals can help sail over the hurdles. Use the following helpful guidelines to get on the best course. The IME Process: Leave It To Industry Professionals Let’s take a look at what is involved in an IME. The process includes: determining the type of exam required; scheduling the appointment; finding the appropriate and credentialed expert; compiling, condensing, and indexing medical records; drafting a cover letter with the relevant questions; delivering the final quality assured report; paying the expert; and handling the dozens of details and logistical support along the way. These activities can consume staff time, and lots of it. There is an opportunity cost too; staff dedicated to managing the highly specialized IME process detracts from their core responsibilities and revenue generating activities. ExamWorks, the leading IME services company, is audited annually and randomly by independent third-parties to ensure IME services (URAC), information security and financial controls (SSAE 16 and Sarbanes-Oxley) comply with the highest standards in these respective functions. The Credentialed Medical Panel Every step of the IME process is critical, starting with the selection of the appropriate physician or allied healthcare professional that will perform the physical examination and write the IME report. ExamWorks has the largest independent medical review panel; medical professionals are credentialed by our network compliance department using primary source verification; re-credentialed every two years or upon expiration of a credential; and monitored round-the-clock for any changes in status, sanctions or infractions. Clients are assured that the independent medical professionals have the licenses, certifications and training to provide specific IME services. Let’s look at how the process works. Identifying the Physician Before scheduling an IME, an ExamWorks service professional conducts a pre-IME assessment and reviews the referral submitted by the law firm to: specify the type of IME required; identify the specialty or multi-specialty physician; and refine the physician selection based on IME-related training. There are many types of IMEs such as Functional Capacity Examinations and Permanent Disability Evaluations. Physicians who perform IMEs have specialized training for these types of examinations; receive continuing medical education; and are familiar with the regulations and requirements of various insurance coverages as they relate to evaluating medical conditions. An IME conducted by a physician without such prerequisites may not address the needs of the case accurately or issue a report that complies with industry requirements. An IME services professional is uniquely equipped to manage these non-trivial tasks. Paying the Independent Physician Expert Typically, law firms are required to pay the expert prior to the exam being scheduled which adds a cash management and administrative burden to the IME process. As an outsourced service provider, ExamWorks manages the billing and collections process. Invoices are not issued until the exam is complete and final report issued. Scheduling the Plaintiff or Claimant IME The management of the scheduling function is a timeconsuming task. Appointments need to be scheduled or re-scheduled, and cancellations and no-shows recorded. Appointment letters need to be sent. Appointments need to be confirmed. IME service professionals manage the scheduling function. ExamWorks has a unique, secure web portal where every aspect of the IME can be viewed around the clock, which is convenient for pre-trail preparation, negotiations and settlements. Multiple firewalls and multilayered encryption protocols ensure that communications, documents and medical record transmission comply with HIPAA requirements. Assembling the Medical Records IMEs, like legal matters, require meticulous preparation. The physician that performs the IME must have all the medical records prior to conducting the exam. Pre-exam preparation on the part of the physician ensures that the examination is considered and thorough. A full-service IME vendor should ensure that the medical records are obtained, available to the physician and client at any time. Delays cost time, money and angst. Using ExamWorks’ secure web portal, medical records can be accessed, uploaded or downloaded by authorized clients, taking the excrutiating delays out of the process forever. Drafting a Cover Letter Quality IME preparation can include a cover letter for the evaluating physician. The cover letter clearly and deliberately states the issues and concerns that should be addressed in the examination. IME service professionals can assist in the development of cover letters. Thorough and advanced preparation ensures that the IME exam and resulting report will be concise and complete, not requiring any addenda. ExamWorks’ web portal tools and service professionals can assist with cover letter development. IMEs: Evidence Over Conjecture A professional IME services firm assists clients to secure a thorough, informed and impartial IME report. There is a difference in the preparation, quality and value of an IME performed by a consulting physician who has not been fully vetted by a professional IME services firm and an accredited, independently audited, full-service IME vendor with a nationwide presence. In the final analysis, clinically-informed IMEs bring evidence rather than speculation to the negotiation and settlement process.
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