Contact Relationship Management: What does your LNC business want to be when it grows up?

Posted by on Feb 27, 2016 in AALNC, Best Practices, Kari Williamson, Legal Nurse Consultant, Legal Nurse Consulting, MK Consulting, Services

By Kari Williamson, BS, RN, LNCC, CCM MKC Medical Management I recently saw a post by a fellow LNC, inquiring: “How do I best manage leads, names, clients, contacts, supportive colleagues, and others while I grow my business?” What’s a LNC to do? There are many Contact Relationship Management (CRM) platforms which boast a variety of functions—in addition to the ol’ tried and true Excel spreadsheet. Some CRMs are very expensive, while others more reasonable. Excel is on most everyone’s computer, is very versatile and can be effective. So how do you choose what would work best for you? What systems work the best? Does a more expensive tool really give you better results? Click over to the AALNC Presidents Blog to see the full blog...

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Top 5 Traits of a Great LNC

Posted by on Jan 18, 2016 in AALNC, Best Practices, Kari Williamson, Legal Nurse Consultant, Legal Nurse Consulting, LNC

By Kari Williamson, BS, RN, LNCC, CCM MKC Medical Management What a difference 18 years makes. I was a rarity way back in 1997, when I became a Legal Nurse Consultant and it was still a fairly new specialty practice. Hardly anyone knew what an LNC was, much less what to do with us. Nowadays, you can hardly swing a stethoscope without hitting one, and attorneys and claim representatives better realize the value of using a skilled LNC to evaluate a claim or review complex medical records. What makes an LNC great and how do you know? And, if you are a LNC, how do you know if you are providing maximum value to your client? Click over to the AALNC Presidents Blog to see the full blog...

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Biomechanics: A way to better understand mechanisms of injury and how the M.O.I. measures up with a claimant’s stated injury

Posted by on Mar 8, 2015 in AALNC, Best Practices, Legal Nurse Consultant, Legal Nurse Consulting, LNC, Medical Conditions/Terminology Blog Series, RN

By Danny Marshall, RN, EMT-P, CLNC What is biomechanics? It is a scientific discipline which applies principles studied in mechanics to the understanding of living organisms. So, what does this mean to the LNC? As a LNC we are challenged to determine if a claimant’s reported injury or injuries can be the result of the mechanism of injury he/she has reported. As a new LNC I have learned this is easier said than done. I am thankful for the LNC who has helped me edit the reports I have completed, she told me to study biomechanics. Studying biomechanics has helped me to better understand the relationship between the M.O.I and the claimant’s reported injuries much better. For example disk herniations are uncommon in front and side impact cars crashes that are severe enough to cause other serious spinal injuries. In laboratory testing, pure compression, torsion and flexion do not result in disk herniation. Only a combination of lateral bending, hyperflexion, and severe compression can cause a herniation. This is usually the result of heavy lifting, but rarely occurs anywhere in the spine during automobile accidents. In rear end collisions the neck is most likely to sustain injury and the thoracic and lumbar spine is less likely due to protection by the seat and restraints. Proper placement of the head rest would be an important piece of information to obtain because it can reduce the chance of whiplash injury to the neck. So a study in biomechanics and how it relates to the body when an injury occurs can be most beneficial to a LNC who is trying to see if the claimant’s reported injury or injuries are a result of the reported M.O.I. or related to another...

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Mechanism of Injury (MOI) and its Role in the World of the LNC

Posted by on Jan 8, 2015 in Blog, Legal Nurse Consultant, Legal Nurse Consulting, LNC, Medical Conditions/Terminology Blog Series

By Danny Marshall RN, EMT-P, CLNC A definition of a mechanism of injury: Describes a particular set of circumstances that caused a given injury. An example: The mechanism of an injury from a car crash will often be described in terms of the speed, angle, and direction of the crash. Emergency medical professionals often take into consideration when assessing and describing the circumstances and causes of an injury. Pretty straight forward, you would think? Not so. As a paramedic I can think of several times I would bring in a patient involved in a motor vehicle accident and describe to the receiving medical team: The type of impact The speed at which the impact occurred The amount of  intrusion into the vehicle If the patient was restrained or not. Only to have the receiving staff not appreciate the importance of the information concerning the mechanism of injury presented to them. These descriptions are of paramount importance in ensuring proper patient care. To ignore these facts could lead to a negative outcome for the patient. So what does all this mean in the world of the LNC? In one simple word, EVERYTHING. The mechanism of injury is the heart and soul for a LNC reviewing medical records for a client. As a paramedic I would always ask what type of injury should I suspect in a patient depending on the type of event that occurred. As a LNC I am asking very similar questions as I review a medical record. Does the type of injury the claimant reports match the mechanism of injury. An example: a person has a slip and fall at a local business and now states a torn rotator cuff was the result of this particular fall. I am now asking similar questions:   How far did the claimant fall What type of surface did the claimant fall on Was it a ground level fall or a fall from a significant height Are there any pre-existing medical issues that could account for the claimant’s current injury pathology The answers to these questions is not to absolve any person or business from responsibility for an injury sustained from someone on their premises or to discredit a person who has sustained an injury. But this is an honest effort to find the truth. This is why a thorough review of medical records is of paramount importance and a healthy understanding of the significance of mechanisms of injury truly is the heart and soul in the world of the...

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Being the Pupil….

Posted by on Dec 9, 2014 in Blog, Legal Nurse Consultant, Legal Nurse Consulting, LNC, Medical Conditions/Terminology Blog Series

By Laura B. Duhamel, RN BSN, CLNC My first blog was about the role of the nurse as a teacher.  The other side of that coin is the nurse as a pupil. As a nurse, my teachers include patients (and their families), colleagues, doctors, attorneys and other nurses.  While a new Legal Nurse Consultant may have years of bedside experience, learning to apply that knowledge in the legal arena has a learning curve that needs teachers and mentors.  The more seasoned LNC can also learn and gain a different perspective from a new nurse and their fresh eyes. It’s important to acknowledge that the teacher/pupil relationship is always evolving.  It also helps to keep it positive.  We teach ourselves through the research we do in the role of a LNC as we help our clients understand the medical issues in their cases. No one knows everything, and even things that are “concrete” can change. Who would have thought that the ABC’s of CPR would have changed? It is all about circulation these days.  A good pupil must be open to new ideas and new ways to achieve the same goals. This means not becoming defensive when a new idea is proposed that challenges  the “usual” way of doing things. Fresh thoughts might be game changing in a given situation. So, be open to new knowledge and listen to your fellow nurses.  They may have experiences in which you have not shared.  Learning is a never ending delight of life.  Be the object that the “point of light” shines on!!! Laura B. Duhamel, RN BSN, CLNC is a legal nurse consultant with MKC Medical Management. You may contact her at lbdlegalnurseconsultant@outlook.com...

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Six ways to avoid getting tripped up by medical records

Posted by on Nov 11, 2014 in Blog, Legal Nurse Consultant, Legal Nurse Consulting, LNC, Medical Conditions/Terminology Blog Series, Uncategorized

Continuity of care and information are critical when reviewing a medical record. Continuum of information, evaluations and treatments start with the initial injury and travel through the medical record. But what first started out as a nice straight line quickly becomes a bowl of spaghetti, with many 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 help you avoid getting tangled up yourself: Look at each medical provider closely and on its own merit. Ask, 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. (See earlier ED blogs). For example, is what was told to the ER triage nurse the same as what was told or documented by the physician? When a claimant or patient is seen by another provider, does the information about the injury/event/diagnosis remain constant and consistent or does it morph into something else? Think of a piece of paper torn in half. Can you line up the edges to recreate that one piece of paper? If information does not line up, then that should be a red flag for the attorney or adjuster that something — some crucial fact or piece of data — may be missing or even misrepresented. 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. 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. Look carefully at what the injured party is reporting/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, treatment and the associated responses. Ask, 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?? As you can see, this process can be daunting, especially for a non-medical person. That’s where LNC’s can help. We are used to following that slippery string of spaghetti. From receiving...

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