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An Independent Medical Examination (IME) is a tool used by insurance adjusters and defense attorneys to assist with the control of treatment duration and cost. IMEs can be used to document an injured person's medical condition, and provide an independent verification that the claimant's medical condition is associated with their injury. An IME should be completed when an injured person receives a higher disability rating than expected or when the recovery seems to be taking longer than expected.
A successful IME requires the careful selection of a doctor in the appropriate specialty with experience treating similar injuries. This specialization can mean patients with multiple health considerations may require more than one IME. This makes choosing the right IME provider imperative.
When choosing an IME program, adjusters need to look for a network provider with demonstrated professional medical evaluative services that will help identify appropriate care on even the most challenging claims. An IME program should provide many choices for claims professionals and have an extended panel of physicians that can meet your specific needs regardless of the size or geographic coverage.
To prepare for an IME the doctor will need all the available information on the claimant's medical condition including: a complete job description, an injury report, all medical records, diagnostic test results, and any other relevant information. After the IME, if there are still questions, it is important to ask the doctor for clarification so the insurer is better able to make fair decisions on how to handle the claim.
To assist with your IME needs the Coventry program offers:
- A national network of credentialed providers
- Exams scheduled within 48 hours
- Streamlined integration of information from Bill Review and/or Case Management
- Prompt turnaround on reports and reduced administrative burden for you
- Nurse Review available to ensure that the case can benefit from an IME
- Established Best Practices and Quality Assurance procedures that ensure all questions are addressed in full in the IME report
- Customized outcomes reporting tool to measure costs, turnaround time, and case detail
- Easy referral through the Claims Sight web portal, email, phone, fax, or in person at your office
- Block time scheduling
- Full-time Regulatory Compliance staff to ensure jurisdictional requirements are met
- Electronic medical document retrieval
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For more information about the Coventry IME Program, please contact your local Account Sales Manager or call 1.800.662.2393. |
