MES Solutions offers Record Review services. Medical Record Reviews by credentialed professionals are a cost-effective way to evaluate claims when a physical examination is not required. MES offers four main types of Record Reviews.
Film Reviews provide an informed independent opinion of imaging diagnostics and reports. Board-certified radiologists review X-rays, CT, or MRI scans to provide a fact-based evaluation of the studies. If historical images need to be sourced, MES professionals can assist with the investigation and retrieval of those images with proper medical authorization.
Record Reviews are a historical and current evaluation of the claimant’s medical history in the context of the claim issues in question. An informed independent medical review evaluates the claim from a different perspective compared to that of the treating provider. Given the complexity and diversity of medical treatments available for different conditions, bill review performed in conjunction with a record review can identify alternatives, efficiencies and in some cases, unnecessary medical spending. The two services are combined into one.
Medical record review can be deployed when clarity is required. Second opinion reviews address issues for which supplementary information and evaluation is required. Specific questions are generally supplied to the medical examiner in order to resolve an outstanding issue to facilitate claim resolution.
Independent medical review requirements vary by state. MES professionals and evaluators are current on the regulations in the jurisdictions where they provide services such as: