Bill Review and Cost Projections

Future Medical Cost Projections

Med-Law Connection brings the expertise and experience necessary to develop future medical cost projections (FMCP) based on the individual needs of your client.

The FMCP is a valuable tool when identifying an injured party’s exposure for future medical costs related to the claimed injury. It provides an estimation of the total medical, durable medical equipment (DME) and prescription drug value of the claim.  It is a very useful instrument for setting accurate reserves and can be a key component for settlement negotiations.

The FMCP report is based on the medical reports from all pertinent treating clinicians including pharmacy as well as the payment history.  The report provides a medical summary that includes the initial injury information as well as current treatment, the future medical needs and any pre-existing or co-morbid conditions.  The report includes an itemized spreadsheet that lists the costs for all medical, DME and pharmacy needs on an annual basis as well as priced out for the life expectancy of the individual. This is also a concise way to demonstrate to a jury in a way that they can understand where the settlement numbers originate.

FMCP’s are typically requested for mediation, arbitration, demand letters, for preliminary determination of future costs, setting aside reserves for insurance companies and non-catastrophic injuries. It is also a cost effective alternative when a Medicare Set Aside Allocation (MSA) or Life Care Plan (LCP) is not necessary. However, the report information can be utilized if an MSA or LCP is necessary within one year of the report.

 

Medical Bill Review

An analysis of medical bills may be necessary to determine accuracy for the services and products that were provided to the claimant related to the claimed injury. This involves a thorough review of the medical records as well as a line item analysis of the bills. This review can also be completed for the purpose of determining medical necessity of medical treatment for any accident-related injuries as well as pre-existing conditions.

A comprehensive review for financial accuracy of the bills may also be completed. This takes into account the usual, customary and reasonableness charges for facilities in their zip code and average billed charges by procedure code and facility.

 

“Med-Law Connection assures that any of these services can be adapted to meet your needs.”

 

Call our Certified Legal Nurse Consultants at (563) 332-9851 or click here to contact us today!