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Medical Bill Reviews

Dawn Cook has completed over 100 Medical Bill Reviews for plaintiff and defense attorneys. Medical Bill Reviews are also known as: Reasonableness of Past Medical Bills, Past Medical Bill Reviews, Medical Audit, Utilization Audit, and Bill Review. The methodology used for Medical Bill Review reports is to review bills and medical records and research the usual, reasonable and customary (URC) charges based on this information.

Validation:

We compare the bills to the medical records to validate that the care given was related to the accident or alleged medical malpractice.

Codes:

We compare the bills to the medical records to ensure the codes are correct for the care documented. If the codes are not correct, we assign the appropriate code and explain. If there is no code on the bills, we research the most appropriate code and add this information to the tables.

Costing:

We provide the usual, reasonable and customary (URC) cost that the research reveals for the geographical area where the treatment or equipment is received.

We show what resources were used to determine these costs. For both defense and plaintiff counsel, a Medical Bill Review report is a concise assessment of the codes and costs and the relationship to the injury.

Review Medical Bills

FAQs

A Life Care Plan is inclusive of all future medical care a patient will need such as medical evaluations, therapy, rehab, counseling, diagnostic testing, surgeries, transportation, home modifications, durable medical equipment, specialized equipment and supplies, home care and personal care support, future hospitalizations and anything else that may be needed or anticipated to be needed for the individual.  Frequency of visits, replacement intervals and estimation of the reasonable and necessary costs are included in the plan.

The American Association of Nurse Life Care Planners (AANLCP) defines a life care plan as a plan that outlines an individual’s needs throughout the healthcare continuum, in multiple settings, and throughout life expectancy. A Life Care Plan must be flexible, with provisions for periodic re-evaluations and updates.  Source: American Association of Nurse Life Care Planners Scope and Standards

Life care planners include a group of health care professionals: nurses, occupational therapists, physical therapists, physicians, psychologists, and rehabilitation professionals.  These professionals obtain the necessary training, experience, and education and sit the exam to become a Certified Life Care Planner (CLCP) or Certified Nurse Life Care Planner (CNLCP).

A life care plan is for any patient who will require ongoing medical care due to an injury or chronic illness including traumatic brain injury, spinal cord injury, birth injury, amputations, chronic pain, cerebral palsy, complex regional pain syndrome and more.

A life care plan rebuttal is a defense analysis and critique of a life care plan created for a plaintiff. 

A defense life care planner reviews the plan created to assist in determining if the plan for future care is medically reasonable and necessary and if the costs are usual, reasonable and customary. 

The plaintiff life care plan; medical records, depositions of the plaintiff and family/caregivers, expert reports and depositions.

A rebuttal will include opinions on the items included in the plaintiff life care plan and whether or not they are reasonable and necessary.  Changes may be suggested, alternatives recommended, or items may be suggested to be removed from the life care plan. 

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