Medical costs tend to have a multiplying effect on the overall settlement value. Therefore, a comprehensive medical analysis is a critical piece of any settlement process involving medical liability.
Getting You to Fair & Final Resolution
Rising’s Settlement Support services address treatment that is unrelated, inflated, or inappropriate to produce a true and accurate reflection of all medical costs. This program integrates our medical bill review, nurse audit and physician peer review capabilities to deliver a complete and thorough analysis of medical bills and records:
- Addresses relatedness of treatment, appropriateness, causal relation, pre-existing conditions and inconsistencies in treatment, billing or coding
- Reprices acceptable treatment
- Determines a suitable medical allowance for the claim
- Serves as powerful negotiation tool to reduce unnecessarily high settlement proposals
Our Settlement Support services are beneficial when one or more of the following exists:
- Claim charges exceed $2500
- More than 15 visits to the same provider
- Questionable relatedness or reasonableness of treatment
- Aggravated or exacerbated pre-existing condition
- Catastrophic or permanent injuries
- Frequent specialty consultations / diagnostic testing
- Delay in reporting the injury or seeking treatment
- Lack of documentation or detailed treatment plan
Rising’s Settlement Support services are often used to support third-party auto/liability cases, and can also support other lines of insurance. Additionally, for settlements that involve Medicare compliance, Rising has a suite of Medicare Settlement Solutions to support such cases.
