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Understanding complex medical facts requires battle-tested medical expertise. If you’re going to war, it pays to have a weapon that gets the job done.
Medical Legal Services
MKC Medical Management’s legal nurse consultants have been helping attorneys and claims representatives with complex, medically-related cases for nearly 20 years.
The MKC Team
Under Kari's leadership, MKC Medical Management has grown from one nurse to a seamless, nationwide network
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We’re a coordinated team. So no matter what the issue or question, we have the resources in place to respond to you quickly, accurately and confidently.
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We operate as a virtual company, delivering more value instead of spending our clients’ money on overhead.
A trained and experienced Legal Nurse Consultant will spot things in the medical record that claims adjuster will probably miss.
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From The Blog
Celebrating 2016, ready for what 2017 brings Last year was a busy year for MKC Medical Management. In 2016, we saw a 15 percent increase in business, thanks to multiple newaccounts coming on board and increased referrals from our existing client base. Along with more clients, our roster of employees also is expanding. We now have 10 legal nurse consultants working for us either as full or part-time contractors. Some have been with us for six years, when we started actively working to grow MKC’s presence. Our newest hire came on board four months ago. All are experienced registered nurses who, together, bring decades of experience in medicine. In fact, after so many years hiring such capable LNCs, I recently shared some tips in Attorney at Law Magazine. And we take our job seriously. Being an MKC LNC is a demanding job with a steep learning curve. We require excellence and continuing education. We meet virtually a couple of times each month to analyze and discuss reports. We’re not surprised by last year’s growth. As medical tests, health records and treatments become more complex, attorneys and claims adjusters are turning to us more often to help them ferret out the most important details of their cases and claims. Emergency room records, especially, are critical to building a solid case, but are growing in complexity and difficult for a layperson to fully understand. In fact, 2017, already, is shaping up to be big. Business is up nearly 30 percent over the same time last year as we work to increase referrals and gain visibility across the industry. In the past several months, you may have seen our articles in prominent publications such as Property Casualty 360. Our article, “10 red flags that could signal fraud for vehicle accidents,” was the...
Continuity of care and information are critical when reviewing a medical record. It all begins with the initial injury, but the continuum of information, evaluations and treatments travels through the entire medical record. And, what first started out as a nice straight line quickly becomes a bowl full of spaghetti with plenty of nuanced twists and turns. It takes an expert’s eye and first-hand experience to follow these long, slippery strands. Here are six tips to avoid getting tangled up yourself: Look at each medical provider closely and on its own merit. Does the information at the beginning of the record hold true at the end of the record? This is particularly important for emergency department records. For example, did both the ER triage nurse and the physician get the same information? Check for consistency: When a claimant or patient is seen by another provider, does the information about the injury, event or diagnosis remain constant and consistent or does it morph into something else? If information does not line up, then that should be a red flag for the attorney or adjuster that something – a crucial fact or piece of data – may be missing or even misrepresented. Pay attention to shift changes: If you are reviewing an inpatient stay record, look closely at the change of shift documentation. Nurses report to other nurses when there is a shift change. Is the information documented by the receiving nurse the SAME as what had been noted earlier by the departing nurse? If not, that’s another red flag. Track the ordering physician: When reviewing a diagnostic report, look at the reported diagnosis and ordering physician. Is this information consistent with other documentation? Sometimes you can determine that a new physician has been brought in on the case...
Sometimes insurers must spend a little more to get best outcome No matter what type of insurance line is involved, medical care will often be the largest part of the claim. The associated care and treatment will be the primary driver of damages. So how do you get a handle on the medical aspects of a claim and the associated charges so that an optimal outcome is achieved? Here are some tips: Be proactive: Don’t wait. Work the claim aggressively. Open medical cases take on a life of their own and can quickly spiral out of control. Review all material as soon as you get it. A single diagnosis code can be a big tip. Use all internal and external resources: Pull out the stops and USE resources – internal and external. Medical review software can help. Medical professionals are just an email away. At MKC Medical Management, we often get questions by phone and email on basic things. Don’t be penny–wise and pound foolish: Sure, medical reviews through experts or software can sometimes be expensive, but, in the long run, they will pay off. Take advantage of the resources. For smaller claims, more basic reviews are always a great place to start. Look at the fundamentals of the case: Really focus on the foundation of the mechanics of the injury. Ask for initial vehicle AND bodily impact points and verify initial complaints against the medical visit, records and police report, if available. Set the reserve early: Early assessment and analysis is key to setting the initial reserve. Do frequent re-assessments against new medical records. If you’re not sure what the records indicate, consult an outside medical provider for additional insight and prognostications. Don’t jump the gun on settlements: Depending on the diagnoses, it may not be advisable. Conditions...