Guest guest Posted May 13, 2011 Report Share Posted May 13, 2011 Yea, I had one ordered toward the end of someone's case not long ago. They actually scheduled it 2 weeks before the case was scheduled to end (1 year post accident). The patient -like yours- showed vast improvements and I was getting ready to discharge her. They ended up cancelling the IME. In your case the Doc will see the improvements made, concur, end treatment, and you'll get reimbursed all the way. ph Medlin D.C. From: drjohansen@... Sent: Friday, May 13, 2011 11:46 AM Subject: IME rationale? I just had a frustrating call with a Farmer's claim adjustor (Oklahoma) who has scheduled an IME on my patient who is nearly resolved ( 16 tx since 2/7/11,steady outcomes assessment reductions, VAS now 1/10, legible chart notes). I have scheduled a closing on this patient after a month's observation to be sure she holds her improvement. Patient has also received acupuncture elsewhere. Adjustor says the IME is tomorrow and she can't change it. I asked if she had questions about our treatment or plan, why didn't she ask them rather than schedule IME without talking to us? No Answer... I don't know how I could have done a better job or documented any better what we have done for this patient. Is this happening to others out there? R Johansen D.C. PC,DABCOChiropractic Life Center12762 SE Stark StreetPortland Oregon 97233Voice 5032557746,Fax 5032550818____________________________________________________________SHOCKING: 52" LCD TVs for $60.34TODAY: Auction site sells 52" LCD TVs for up to 98% off retail price.SmartStyleLiving.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2011 Report Share Posted May 13, 2011 I had a similar case a few years ago. I had actually done a one month closing exam and the examiner decided not to pay the $75 fee and send the patient to an IME. My conversation with the claims examiner went something like this… “You’ve paid $1000 in medical expenses for this case so far. This case is totally wrapped up for another $75 dollars and then it will be off your desk. However this IME is going to cost you $400 and the IME doc will opine that the patientis at MMI with no residuals, which is what I said. Then I’m going to tell the patient they are responsible for my $75 bill. Then advise them to seek an attorney. At that point the attorney will not want to be satisfied with 30% of a $1000 case and will recommendthe patient continue care, get motion x-rays and maybe a MRI to look for instability, and get a back to work evaluation. The attorney will also inform the patient that they have the right to seek a settlement, something the patient is not looking for at thistime. Given the damage to the car, missed work and emotional suffering. you’re probably look at a $10,000 settlement. I’m not telling you how to do your job, but this seems like a no brainer.” IME was canceled and I got the check for $75 two days later! Glenn Sykes, DC Gresham Town Fair Chiropractic ClinicPhone: (503) 667-6744Fax: (503) 661-7896WWW.GRESHAMCHIROPRACTOR.NET From: [mailto: ]On Behalf Of drjohansen@...Sent: Friday, May 13, 2011 11:46 AM Subject: IME rationale? I just had a frustrating call with a Farmer's claim adjustor (Oklahoma) who has scheduled an IME on my patient who is nearly resolved ( 16 tx since 2/7/11,steady outcomes assessment reductions, VAS now 1/10, legible chart notes).I have scheduled a closing on this patient after a month's observation to be sure she holds her improvement. Patient has also received acupuncture elsewhere. Adjustor says the IME is tomorrow and she can't change it. I asked if she had questions aboutour treatment or plan, why didn't she ask them rather than schedule IME without talking to us? No Answer... I don't know how I could have done a better job or documented any better what we have done for this patient. Is this happening to others out there? R Johansen D.C. PC,DABCOChiropractic Life Center12762 SE Stark StreetPortland Oregon 97233Voice 5032557746,Fax 5032550818____________________________________________________________SHOCKING: 52 " LCD TVs for $60.34TODAY: Auction site sells 52 " LCD TVs for up to 98% off retail price.SmartStyleLiving.com __________ Information from ESET NOD32 Antivirus, version of virus signature database 6105 (20110508) __________ The message was checked by ESET NOD32 Antivirus. http://www.eset.com__________ Information from ESET NOD32 Antivirus, version of virus signature database 6105 (20110508) __________The message was checked by ESET NOD32 Antivirus.http://www.eset.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2011 Report Share Posted May 13, 2011 Farmer's is the worst. Gatti is most likely working on this as we type. Danno IME rationale? I just had a frustrating call with a Farmer's claim adjustor (Oklahoma) who has scheduled an IME on my patient who is nearly resolved ( 16 tx since 2/7/11,steady outcomes assessment reductions, VAS now 1/10, legible chart notes). I have scheduled a closing on this patient after a month's observation to be sure she holds her improvement. Patient has also received acupuncture elsewhere. Adjustor says the IME is tomorrow and she can't change it. I asked if she had questions about our treatment or plan, why didn't she ask them rather than schedule IME without talking to us? No Answer... I don't know how I could have done a better job or documented any better what we have done for this patient. Is this happening to others out there? R Johansen D.C. PC,DABCOChiropractic Life Center12762 SE Stark StreetPortland Oregon 97233Voice 5032557746,Fax 5032550818____________________________________________________________SHOCKING: 52" LCD TVs for $60.34TODAY: Auction site sells 52" LCD TVs for up to 98% off retail price.SmartStyleLiving.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2011 Report Share Posted May 13, 2011 Ron , I think it is futile to understand the actions of insurance companies sometimes. I have had similar IME's and sometimes you can talk them out of it and sometimes they go ahead anyway. Usually your bills will be paid. It helps to have a good lawyer working in the mix here.A call from the lawyer can work wonders. Schneider DCPDXOn Fri, May 13, 2011 at 11:46 AM, drjohansen@... <drjohansen@...> wrote: I just had a frustrating call with a Farmer's claim adjustor (Oklahoma) who has scheduled an IME on my patient who is nearly resolved ( 16 tx since 2/7/11,steady outcomes assessment reductions, VAS now 1/10, legible chart notes). I have scheduled a closing on this patient after a month's observation to be sure she holds her improvement. Patient has also received acupuncture elsewhere. Adjustor says the IME is tomorrow and she can't change it. I asked if she had questions about our treatment or plan, why didn't she ask them rather than schedule IME without talking to us? No Answer... I don't know how I could have done a better job or documented any better what we have done for this patient. Is this happening to others out there? R Johansen D.C. PC,DABCOChiropractic Life Center 12762 SE Stark StreetPortland Oregon 97233Voice 5032557746,Fax 5032550818 ____________________________________________________________SHOCKING: 52 & #34 LCD TVs for $60.34 TODAY: Auction site sells 52 & #34 LCD TVs for up to 98% off retail price.SmartStyleLiving.com -- Schneider DC PDX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2011 Report Share Posted May 13, 2011 Ron, Some adjusters are more reasonable than others. And yes, they can cancel the IME if they learn new information; especially with some lead time (>48 hours). Might want to speak with the supervisor; five minute phone call, peace of mind that you did the right thing. If the patient isn’t seeking damages, you could declare them medically stationary prior to the exam and then they could go to the exam and be declared medically stationary x2. Might be fun to chat with them about how a patient history is taken and to report no pain, no dysfunction, no problems, except a dull pain in the butt from having to attend a useless appointment. If they are seeking damages, an IME at this point may harm the patient’s case. (I’m not an attorney but I once stayed at a Holiday Inn Express) I have seen reports where the IME says (with the aid of time travel) that the patient was less injured than the care, which has already been delivered, indicated. To me that’s like saying that the tutoring that a kid got wasn’t necessary because they can clearly perform algebra now. Impossible opinion to defend but it still hurts their case. That’s why IME’s go in the bathroom at seminars and conventions in pairs. Too many “noogie attacks” with no security cameras. E. Abrahamson, D.C. Chiropractic physician Lake Oswego Chiropractic Clinic 315 Second Street Lake Oswego, OR 97034 503-635-6246 Website: http://www.lakeoswegochiro.com From: Ron Johansen <drjohansen@...> Date: Fri, 13 May 2011 18:46:12 GMT < > Subject: IME rationale? I just had a frustrating call with a Farmer's claim adjustor (Oklahoma) who has scheduled an IME on my patient who is nearly resolved ( 16 tx since 2/7/11,steady outcomes assessment reductions, VAS now 1/10, legible chart notes). I have scheduled a closing on this patient after a month's observation to be sure she holds her improvement. Patient has also received acupuncture elsewhere. Adjustor says the IME is tomorrow and she can't change it. I asked if she had questions about our treatment or plan, why didn't she ask them rather than schedule IME without talking to us? No Answer... I don't know how I could have done a better job or documented any better what we have done for this patient. Is this happening to others out there? R Johansen D.C. PC,DABCO Chiropractic Life Center 12762 SE Stark Street Portland Oregon 97233 Voice 5032557746,Fax 5032550818 ____________________________________________________________ SHOCKING: 52 " LCD TVs for $60.34 TODAY: Auction site sells 52 " LCD TVs for up to 98% off retail price. <http://thirdpartyoffers.juno.com/TGL3142/4dcd7cc15ae493ec3e2st03vuc> SmartStyleLiving.com <http://thirdpartyoffers.juno.com/TGL3142/4dcd7cc15ae493ec3e2st03vuc> Quote Link to comment Share on other sites More sharing options...
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