Tips, Trends & Findings

Posted by on Mar 7, 2017 in Blog

Here are studies, reports and stories that caught our eye in the last month. Changes for casualty insurance market: An article in Property Casualty 360 ticks off the 10 trends that are expected to shape the market this year. They include increased employer and workers’ compensation complexities, more underwriting scrutiny and a push for higher casualty rates, among others. Patients skeptical of healthcare information technologies: Concerns about cybersecurity are among the reasons why more than half of consumers are leery of the benefits of healthcare information technologies such as patient portals and electronic health records, according to an article in FierceHealthcare. What’s more, 70 percent of Americans don’t trust health technology, up from only 10 percent three years ago. Sepsis readmissions: Sepsis is a leading cause of unplanned hospital readmissions. And, once there, patients’ hospital stays are longer and more expensive when compared to those with heart failure, pneumonia and other illnesses, according to a study in JAMA. Researchers make recommendations for ways to reduce readmissions and cut costs. Technology helping with diagnosis: An article in MIT Technology Review explores the new technologies, including smartphones and machine learning, that uncover vocal patterns that could help doctors diagnose everything from post-traumatic stress disorder to heart disease. Opioid alternatives: As healthcare professionals and entrepreneurs look to curb the use and abuse of opioids, new technologies on the market seek to offer alternatives to opioids for chronic pain. An article on CNBC.com covers this growing class of FDA-approved devices. For more great information and topics, check out our blog on MKC Medical...

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Google Glass, your doctor and you

Posted by on Feb 28, 2017 in Blog

How technology is helping doctors spend more time with patients, less time with paperwork The next time you’re at the doctor’s office, it might not be just you and your doctor involved in the conversation. A medical scribe also could be listening in thanks to new technology that uses Google Glass, the headgear that looks like a pair of glasses, but is connected to the Internet. It’s touted as a timesaver for doctors, who spend as much as 35 percent of their day on recordkeeping. Proponents also say it’s a better way for doctors to build relationships with their patients because they can look them in the eye instead of down at computer screens or a clipboard to check and update records. With the software, made by Augmedix, doctors put on a pair of Google Glasses, which have a camera and microphone built in, and are able to interact with their patient’s medical records with simply their voice. During the visit, a medical scribe watches and listens in. The scribe, trained to work with a particular practice, can answer the doctor’s questions about a patient’s history, for instance, and, once the exam is over, help ensure the records for that day’s visit are complete. For doctors, the technology allows for hands-free recordkeeping as they direct medical record updates with simply their voice. Doctors must approve any records before it becomes part of a patient’s permanent record. The service also complies with HIPAA requirements. According to an article for Stanford University’s medical school, patients sign off that they want to use the service before they meet with the doctor. Nearly 100 percent of patients agree, said Pelu Tran, the company co-founder who was a Stanford medical student when he launched the company. Scribes for Augmedix work from offices in San Francisco and India in sealed-off rooms and must leave pens, paper, smartphones and other belongings outside, according to an article in the Washington Post. The company is growing by leaps and bounds with big customers – Dignity Health, Sutter Health, and TriHealth, among them – and big investments. So far, funding has totaled more than $60 million, according to an article in Medscape. At the Consumer Technology Association 2017 Digital Health Summit in January, Augmedix cofounder and CEO Ian Shakil called Google Glass the “stethoscope of this century,” according to the Medscape article. And it’s expected to help fuel the medical scribe industry. By 2020, a report in JAMA estimates that doctors will employ about 100,000 scribes or one scribe for about every nine doctors. There were about 20,000 medical scribes in 2014. As the technology and acceptance grows, it could be a boon for patients and doctors. Patients get...

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Banner Business Year

Posted by on Feb 21, 2017 in 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 fifth most popular article on Property Casualty 360’s website in January. We look forward to all of the possibilities and continued opportunities in store for MKC Medical Management in 2017. And we are eager to help our clients – new and existing – get to the bottom of the claims and cases on their desks. Let us know how we can help...

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Six ways to avoid getting tripped up by medical records

Posted by on Feb 14, 2017 in Blog

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 as that physician is the “ordering physician.” This is especially true for outpatient diagnostic studies. Remember: Consistency and continuity are key. Examine what the injured party is reporting or describing to each provider. Is it consistent or does it change or grow? The information should be fairly consistent and make sense in the context of the alleged event and throughout ongoing treatment documents. Follow the trauma timeline through the record. Look at timing and treatment, along with the associated responses. Did something new or different appear long after the initial injury? If so, is it a secondary complication or truly a horse of a different color? This process can be daunting, especially for a non-medical person. That’s where Legal Nurse Consultants can help. We are used to following that slippery string of spaghetti. From receiving a report from a medical colleague to documenting the reason for a test, a nurse...

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The Cost of Doing Business

Posted by on Feb 7, 2017 in Blog

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 such as burns and head trauma often improve with time. In fact, for many conditions, maximum medical improvement, the point when a patient’s condition is stabilized, is not until two years after an injury. Evaluate, review and consider ALL co-morbidities: Diabetes, hypertension, osteopenia, peripheral vascular disease and many psychiatric conditions can have an influence on the injury sustained. If you don’t know the impact, ask a medical professional.      Look at the medical case as a whole: Don’t just review the narrative or bills on their own. Review the documentation side by side. Are critical pieces of information missing? Seek an outside film review: This may sound expensive, but, when possible, have a physician review the actual films, especially if you don’t have the written diagnostic report. Anticipate higher emergency department care: The cost for all emergency department care is going up and becoming more costly every year. Review ALL...

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Six ways to help aging workers stay on the job

Posted by on Jan 31, 2017 in Blog

The workforce is getting older. The U.S. Bureau of Labor Statistics reports that the rate of workers age 55 and up in the labor pool has gone up in recent decades – and will continue to climb. The changing faces at the conference table mean employers must take a hard look at their policies and procedures – especially those that relate to workers’ compensation and other claims. Thanks to normal aging, older workers are at higher risk for chronic diseases, take more time to recover and face other age-related setbacks. How can employers help? Through innovative programs. Here are six options. Read more in our recent article at Property Casualty 360. Launch wellness programs and encourage participation. Make sure they address the needs of your older workers and encourage healthy lifestyles. Offer ongoing workplace physicals. If health issues crop up, an employer may be able to make changes to job duties. Project costs based on an older worker’s ability to recover. Keep in mind that older workers may take more time to heal from a surgery or setback and could need extra therapy. Create a committee to discuss all older workers’ claims early on. Quick referrals to the right medical doctor, along with more regular follow ups, may be in order. Evaluate potentially protracted losses. This depends on the job, but they need to be done early by nurses at a local clinic or through case management. Let them mentor: If older workers can’t physically get back to work, consider letting them take a leadership or mentoring role, which could reduce loss time and worker’s compensation payments. After all, older workers bring much more than achy backs to the job. They offer a wealth of experience and knowledge and are playing big roles in today’s offices and job...

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