Karla Painter, Record Solutions, LLC
What is a Medical Record
Search? How will this
search help the adjuster make a decision about questionable claims?
Most adjusters have
experienced a claim that made them suspicious.
The claimant is not completely forthright when asked about
medical history. The
claimant cannot remember names of past physicians or are evasive when
asked direct question about medical history.
Without past medical records there is no way to prove or disprove
pre-existing conditions. Investigation
can be expensive especially when all you have to go on is a gut feeling
and the existence of Red Flags in regard to the claim.
A Medical Record
Search could be the answer. This
investigative service will provide the adjuster with information that
could be crucial to settling the claim quickly or directing the adjuster
to investigate the claim in more detail. This one service can reveal
providers who have seen the claimant in the past.
A list of providers never mentioned by the claimant is now
available. These records may reveal medical conditions that affect the
claim. It also sheds light on the integrity of the claimant.
Has this person withheld information that is pertinent to the
case? This search may also reveal the claimant is being truthful
allowing the adjuster to pay the claim in good faith
The adjuster simply provides name, date of birth, social
security number, address of the claimant and a signed release if
available. A demographic
search of hospitals, family physicians, orthopaedic physicians and
chiropractors will reveal if the claimant has been seen.
Other areas of medicine can be researched as they apply to the
claim. The information
obtained varies from provider to provider.
Some offices will give dates of service and why the person was
seen. Other providers will
only acknowledge the patient has been seen. A report showing all
providers contacted with their addresses and telephone numbers will be
presented to the adjuster.
The adjusters who have been using this search have
expressed the importance of the information provided to them. A Medical
Record Search is a simple inexpensive way to reveal the integrity of a
claimant. Most importantly,
a Medical Record Search will provide the adjuster with information to
make an educated decision in regard to paying a claim or denying a
claim.
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