All our IME’s, Peer & Film Reviews are produced utilizing NCEI’s exclusive Value Plus Medical Request & Report System.
Inefficiency and added cost are often incurred at the inception of the IME process. NCEI’s Service Consultants carefully assess each referral to:
- Insure the appropriate specialist is being requested
- Determine if a physician with an additional specialty or certification is required
- Ascertain if special handling is appropriate or indicated
The IME process is profoundly influenced in quality and outcome by how it’s initiated. Request Review brings the focus and expertise at the front end of the IME process needed to favorably influence its outcome.
Medical Report Red Flagging
NCEI employs a structured Red Flagging process for all our medical reporting. The objective is to surface and highlight medical data and findings not obviously consequential that may have a significant impact on claim resolution or case adjudication. The NCEI Red Flagging process affords incomparable support to claims adjusters.
NCEI’s Medical Report Red Flagging process assesses data with an acute sensitivity to:
- Findings beyond the logical scope of injuries claimed
- Findings radically inconsistent with standard benchmarks and protocols
- Patterns suggestive of error or fraud
- Critical omissions
- Data inconsistencies
Medical Report Red Flagging pays significant dividends, especially when applied to a large number of IME’s over a significant period of time.
Fraud Sensing Analysis
Fraud constitutes a multi-billion dollar liability to the insurance industry and society at large. NCEI utilizes data gathered in the IME, Peer & Film Review process to uncover inconsistencies suggestive of possible fraud. NCEI employs a 7 Point Screening Process to surface and report data suggestive of fraud to our clients.
In our experience, one in ten IME processes undertaken surface data suggestive of possible fraud. If fraud is averted or discovered in a very small percent of these cases, the savings over time would be very significant!