Medical Legal Review Support For Insurance Companies

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Insurance companies receive thousands of medical claims every day and face the onerous task of determining whether they are genuine or not

. Medical legal review support service providers help insurance companies evaluate these claims and avoid cases of fraud that may arise in complex medical cases involving medical negligence, accidents, personal injury, workers compensation and disability. Mismanagement of claims can lead to huge financial losses for insurers.

Legal Review for Insurance Companies

Support service providers offering medical review services for insurance companies help identify and resolves claims with medical legal issues. They help insurers in screening each and every case for merit. Their assistance is invaluable when it comes to determining whether a claim should or should not be reimbursed. This is significant both from the point of view of the insurer and the insured. The support services that an efficient medical review company offers insurance companies cover:

Medical record organization: Medical records contain all the necessary information pertaining to the claimant. Medical records have to be organized in a sequential manner, starting from the admission of the patient up to discharge. It is ensured that no relevant records are omitted. All forms containing both medical and non-medical information are organized so that they can be retrieved and read easily. All paper records are secured so that nothing is lost. All documents are arranged in chronological order.
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Medical claims review: Medical legal review service providers review all the submitted claims for validity. Codes are checked for accuracy. Their services help to make sure that claims are paid in accordance with health plan benefits and conditions. They can help insurers detect errors in payment and mistakes.

Summaries of medical records: Medical review support service companies also provide concise medical record summaries. A well-prepared summary makes it easy to detect case-specific information and events such as hospital stay details, physician opinions, test results, medication and much more.

Litigation support with pertinent literature references, research, and preparation of materials: Physicians and attorneys handling complex claim cases for insurers are also offered research support to prepare for a hearing.

Timely and Affordable Medical Legal Review Services

Competent outsourcing companies offering medical legal review support for insurance companies ensure them timely services to avoid financial losses and meet legal deadlines. Insurance companies have to handle complex claims which are difficult to resolve. The medical legal support they receive from an efficient medical review company helps them make timely decisions on claim payment.

by: MOS

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