Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 1184
Lawyers and Medical 82 L

From the Desk of Dr. Mark Studin
Academy of Chiropractic

Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time. -Mark Studin 2006

"P-IME & Peer Review Process"

 

Dr Studin: So what was your question up front?

Guest Dr: So I'm wanting to get some clarification about your plaintiff IMEs. So I've listened to the podcast and read some of your issues that you send us emails. So when I meet with an attorney, can you explain to me more specifically exactly on what it is and what I need to do.

Dr Studin: first, just from a conceptual perspective, just a little bit of historical background, about 10 years ago, maybe 15 years ago, I woke up one day and I said, we have two types of IMS. There's an independent medical examination, which we all know that's not true, ordered by the insurance company, Then 30 years ago, maybe half of more fair. And then the last 20 years I haven't seen a fair one out there. I don't know if you have, there are always skewed away from us. And then there's a defense IME ordered by the lawyer when they have to go to trial and they hire an expert so that the expert can go on the witness stand and puts all the information together and sometimes even evaluates the patient so you have a defense medical examination. I said, what's wrong with having a plaintiff IME, So that was a phrase that I coined, many years ago. And I did a bunch of the locally in New York for four different attorneys that I work with and all of them have positive experience. And then I turned to Dr. Rollins in Buffalo while he was still a client before he started consulting and I said, bill, I want you to do these. So I went up to Buffalo and I lectured to about 80, right after that seminar, bill got up and he said, listen, dr student explained all of these things and it was really rudimentary compared to what we do now, but I want to do all your second opinions. No one's doing them. So Just in second opinions to me that 80 lawyers in front of me. So I was able to, proverbially tenderize them and lead them down the garden path. Bill was getting about 20 to 30 plaintiff IMS a month, and he was charging at that point in time $500. And he just said to the lawyers give me a tough cases, give me the all. And one by one the lawyers stopped sending plaintiff by IMS to him because that confidence in him because they were prevailing where they were losing and now they only send fresh cases to him. So today he gets zero Plaintiff IMEs they are all fresh cases, because all the lawyers in the region are now referring to him. So that's the business strategy. Now what a plaintiff IME is it's nothing more than a second opinion. You're doing a 99245 That's your code examination of a patient where you're not treating them 99245, you could bill a carrier for it, I choose to just lean the case against it. Now I personally get $1,500 for it, you can pick your own fee. Examination and report and meeting with the Lawyer to explain it, but what you do is you're filling in any diagnostic dilemmas because the majority of providers are clueless about MRI, EMG, functional laws, duties under duress, loss of enjoyment of life, concussion issues. So you order any tests that you feel the need to, and then you hire dr Schoenfeld to write the report for you. You don't spend time writing your own reports. So over time when you start meeting with the lawyers and going through this, you will now be expert at this and then they'll start working with you. But while you get to that point, we have to talk about offices, and lawyers have to see you as an expert. So number one, you've got to have your CV on the US Chiro directory so they can see you. You need a website with pictures of your clinic. And your clinic also has to reflect with my signage out front clinic, because they're coming in. Your walls have to have your diplomas on it, it's a total package. Did I answer your question?

Guest Dr: Yes you did. And then what about the records review? How was that different records or view as a peer review?

Dr Studin: so you're not seeing the patient, you're doing a record review now, by the way, you should charge $250 an hour for a record review. And by the way, say you're charging $750 for a peer review, a plaintiff IME, I consider that which includes the best 50 pages of documentation. If this some lawyers you'd be 400 pages of medical records to review. It's $250 an hour edition, after the first 50 pages. So peer review or record review as a peer review, $250 an hour, the average is three hours. You tell them, then you hire dr Minoni who designed the rebuttals, he actually will help sift through all the records and write their reviews. So you keep the balance, but you're going to have to still go through them at the end, and perhaps write conclusions and understand it. 

"P-IME and Peer Review Process"

 

Dr Studin: So what was your question up front?

Guest Dr: So I'm wanting to get some clarification about your plaintiff IMEs. So I've listened to the podcast and read some of your issues that you send us emails. So when I meet with an attorney, can you explain to me more specifically exactly on what it is and what I need to do.

Dr Studin: first, just from a conceptual perspective, just a little bit of historical background, about 10 years ago, maybe 15 years ago, I woke up one day and I said, we have two types of IMS. There's an independent medical examination, which we all know that's not true, ordered by the insurance company, Then 30 years ago, maybe half of more fair. And then the last 20 years I haven't seen a fair one out there. I don't know if you have, there are always skewed away from us. And then there's a defense IME ordered by the lawyer when they have to go to trial and they hire an expert so that the expert can go on the witness stand and puts all the information together and sometimes even evaluates the patient so you have a defense medical examination. I said, what's wrong with having a plaintiff IME, So that was a phrase that I coined, many years ago. And I did a bunch of the locally in New York for four different attorneys that I work with and all of them have positive experience. And then I turned to Dr. Rollins in Buffalo while he was still a client before he started consulting and I said, bill, I want you to do these. So I went up to Buffalo and I lectured to about 80, right after that seminar, bill got up and he said, listen, dr student explained all of these things and it was really rudimentary compared to what we do now, but I want to do all your second opinions. No one's doing them. So Just in second opinions to me that 80 lawyers in front of me. So I was able to, proverbially tenderize them and lead them down the garden path. Bill was getting about 20 to 30 plaintiff IMS a month, and he was charging at that point in time $500. And he just said to the lawyers give me a tough cases, give me the all. And one by one the lawyers stopped sending plaintiff by IMS to him because that confidence in him because they were prevailing where they were losing and now they only send fresh cases to him. So today he gets zero Plaintiff IMEs they are all fresh cases, because all the lawyers in the region are now referring to him. So that's the business strategy. Now what a plaintiff IME is it's nothing more than a second opinion. You're doing a 99245 That's your code examination of a patient where you're not treating them 99245, you could bill a carrier for it, I choose to just lean the case against it. Now I personally get $1,500 for it, you can pick your own fee. Examination and report and meeting with the Lawyer to explain it, but what you do is you're filling in any diagnostic dilemmas because the majority of providers are clueless about MRI, EMG, functional laws, duties under duress, loss of enjoyment of life, concussion issues. So you order any tests that you feel the need to, and then you hire dr Schoenfeld to write the report for you. You don't spend time writing your own reports. So over time when you start meeting with the lawyers and going through this, you will now be expert at this and then they'll start working with you. But while you get to that point, we have to talk about offices, and lawyers have to see you as an expert. So number one, you've got to have your CV on the US Chiro directory so they can see you. You need a website with pictures of your clinic. And your clinic also has to reflect with my signage out front clinic, because they're coming in. Your walls have to have your diplomas on it, it's a total package. Did I answer your question?

Guest Dr: Yes you did. And then what about the records review? How was that different records or view as a peer review?

Dr Studin: so you're not seeing the patient, you're doing a record review now, by the way, you should charge $250 an hour for a record review. And by the way, say you're charging $750 for a peer review, a plaintiff IME, I consider that which includes the best 50 pages of documentation. If this some lawyers you'd be 400 pages of medical records to review. It's $250 an hour edition, after the first 50 pages. So peer review or record review as a peer review, $250 an hour, the average is three hours. You tell them, then you hire dr Minoni who designed the rebuttals, he actually will help sift through all the records and write their reviews. So you keep the balance, but you're going to have to still go through them at the end, and perhaps write conclusions and understand it. 

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