What’s the best practice? Both.
When reviewing medical records, it may seem redundant and not at all cost effective to pay for both a physician’s peer review and a legal nurse consultant’s examination of the same claim or case.
They both, however, offer unique perspectives. And, when you combine the two, the result affords you a more complete timeline of both the events that have happened and the medical future for the patient.
The Physician Peer Review
A physician peer review or medical review of a case can give you a pinpointed, detailed reporting of what has happened to date. It provides intricate details about specific pieces associated with the medical event and how those pieces fit directly together.
More myopic in construction than an LNC report, the medical review yields very precise answers and insight into a medical event and the subsequent treatment strategies. Simply put, it’s a very accurate snapshot in time of the patient and the event.
The LNC Report
Also a major standard in the industry, an LNC takes the medical review and expands it. MKC nurses create a detailed medical record summary with ongoing embedded commentary, helping the reader understand both the material and its impact on the case. Contact us if you would like to see a sample report.
An LNC report provides information about peripheral factors relevant to the case as well. It also considers long-term patient care and interaction, pre-accident medical information, specific information about the mechanism of injury and ongoing details pertinent to the injury and case. This broader approach often uncovers inconsistencies that may otherwise go undetected.
An LNC’s granular level of review is equally important to the case as the focused review of the physician. As one claims examiner once explained, “We know we will never have a silver bullet on these cases, but what is more valuable is that with the nurse review the details of the record evolves into a shotgun effect, thus exposing equally important details that are often missed.”
Using a Whole Person Approach
The patient involved may have a single event or episode, but the effects and ramifications of that single event can weigh heavily on the future treatment of that injured party.
By using both reports, you gain a more complete picture of the claim, the specific injuries and the prognosis.
Without using both reports, you could very well end up making future patient decisions with one eye closed.