Efficient & Affordable

Efficient & Affordable

We operate as a virtual company, delivering more value instead of spending our clients’ money on overhead.

More Competent

More Competent

A trained and experienced Legal Nurse Consultant will spot things in the medical record that claims adjuster will probably miss.

Seamless & Accessible

Seamless & Accessible

Our company is open 24/7. No matter what the issue or question, we respond to you quickly, accurately and confidently.

From The Blog

Separating the subjective from the objective

When Legal Nurse Consultants analyze medical records, we had better be able to compare and contrast subjective and objective documentation. In other words, we earn our keep by determining what constitutes a subjective complaint versus an objective finding. Sounds simple right? Not so fast! While these terms are used all through medical documentation, they can be confusing. Here are just a few reasons why: Non-medical people often mix the terms Medical records themselves can be confusing Attorneys and claims representatives often don’t understand the condition or clinical picture from a medical perspective Information that falls under each of the objective or subjective categories are often misunderstood, misquoted or confused. To make matters even worse, there are medical terms that actually can fall under BOTH categories. A case in point Here is an actual physical exam taken from one of our company’s case files: Physical exam: Abrasion to left knee, right 5th finger, thumb and chin. Lips also noted to be swollen. Elevated BP. Swelling noted to right hand, limited range of motion, decreased strength, tenderness to touch. Glasgow coma score 15/15. Neurovascular intact. So, is the physical exam findings objective or subjective? First, let’s review the definitions of subjective and objective. Subjective Definition: Information that is reported by the patient, BUT can’t be verified or perceived by the examiner. The examiner should document SUBJECTIVE COMPLAINTS. The term subjective findings (or subjective symptoms) is wrong. Examples: “Feeling hot,” “pain,” “numbness,” “tingling” or “nausea.” Objective Definition: Measurable abnormality or finding that is perceived by the examiner. The examiner would document OBJECTIVE FINDINGS. Examples:  Lab or diagnostic testing; fracture visible on xray; bruising; swelling;redness. So let’s take another look at that physical exam. Here’s a map, pulling out the objective and subjective elements: Abrasion (objective) to left knee, right 5th finger, thumb...

Gym Revelations

The importance of isolating muscle groups – and case records For years, I’ve been going to the gym. I’ve run through the same workout week in and week out. I thought I was doing a great job, honing in on specific muscle groups and staying fit. So, when a personal trainer suggested I do those triceps exercises that I’ve always done with three-pound weights, not 10-pound ones, I was a little skeptical. Why? I’ll never work those muscles with just three pounds of weight, I thought. And then I did it. After the third set of 20 reps, my triceps were screaming. It turns out, I’d been doing it wrong all of the time. And, let’s just say, I’ve been taking my personal trainer’s advice ever since that day. He knows the equipment. He’s read up on the latest research. And he knows the importance of isolating those muscle groups for the most efficient and effective workout. What does this have to do with legal nurse consulting? A lot. We know the equipment. Our LNCs bring decades of experience as registered nurses. We know our way around complex medical records, including the digital kind, and complicated diagnoses. We’re always on the lookout for red flags when evaluating, for instance, a motor vehicle accident injury. We know ways to avoid getting tripped up by the pages and pages of medical records that come with just about every case. And, whether it’s lead poisoning or workplace back injury, we know the tough questions to ask – and what records are critical to figuring out exactly what happened. We know the latest research. Opioids should no longer be the go-to pain killer for certain injuries. ICUs may be overused. Let’s talk the biomechanics of minor automobile accidents. As a lawyer or insurance...

Getting to the ‘tooth’ in dental claims

Reviewing dental claims is a regular part of our job at MKC Medical Management. But the work isn’t as clear cut as it might seem when you’re dealing with a cracked tooth or gum lacerations. They often take a lot of sleuthing. Let’s look at one case we reviewed. A man was reportedly struck on the left side of the chest. The claimant reported that he fell and injured his left knee and chest. Buried in the same records, however, was a costly dental restoration plan. Based on the facts, I wondered how the claimant could justify such a thing. So, I started with the emergency department records. Checking the facts I reviewed everything and cross referenced the alleged event facts and ALL of the objective data, including the lab tests and diagnostic results. I looked at pieces of information tucked in the emergency room nurse’s triage notes, what the EMS documented, the treating physician’s exam and the discharge orders. In other words, I looked at everything. I really focused on the subjective complaints and reported information  In fact, I reviewed everything three times! And, guess what?! NO oral trauma was documented. There was NO subjective complaint regarding oral, dental, teeth, gum pain or trauma. In fact, the claimant self-reported NO head trauma. Furthermore, there was an entry documenting “no oral trauma.” None of the hallmarks of oral trauma were there:  No blood, no laceration, no missing or cracked teeth. NO oral pain. Instead, the exam stated, “Oral mucosa, pink and moist.” Wait, no oral trauma? So, I am thinking, why did the carrier send this file? I kept digging. Because nothing is really obvious, is it? I discovered that the records reported that the claimant received chiropractic care about three days after the incident date. But there was...

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