Nurse Consultation Services

Our Nurse Consulting Services provides a comprehensive analysis of medical treatment costs relative to necessary charges, ensuring maximum savings.

Our nurses offer the following services:

  • Usual and Customary Review (UCR)

  • Billing Code Review (BCR)

  • Surgical/Settlement Cost Projection

  • Medical Doctor Questions

  • Medical Records Chronology

Usual and Customary Review (UCR)

A nurse consultant will use one of the industry’s leading independent Usual and Customary databases to show how your bill compares to what other providers in a specific geographical area charge for the same services. You can use this report alone, with the Billing Code Review, or as an adjunct to your IME or medical file review physician’s report.

Billing Code Review (BCR)

If you want to ensure that you’re being billed correctly for the services performed, a nurse consultant will review your invoices and compare each charge and CPT code against the clinical documentation. Our nurses comb through the records to ensure each HIPAA-mandated billing code is supported and coding rules are followed to ensure accurate charges.

Surgical Cost Projection

Surgical Cost Projection reports estimate the cost of proposed future medical, dental and surgical procedures, as well as the cost of anesthesia, care facilities, durable medical equipment, supplies and standard post-op care including physical therapy.

A nurse consultant prepares the report, using the appropriate CPT codes to provide the details needed to value compensation. These codes are verified through a fee schedule database that determines costs by zip code, so you have a detailed breakdown of potential future expenses.

Medical Doctor Questions

A nurse consultant will prepare you to speak with your IME or medical file review physician by reframing your existing questions with one from a standard list, ensuring you receive the appropriate answers required for claim settlement.

Medical Records Chronology

Medical Records Chronology (MRC) condenses volumes of medical records into a succinct report, including an outline of the information in non-medical language. The medical records will be organized chronologically, from earliest treatment to the present day. This will allow you to view care providers and patterns of treatment, while also keeping an eye out for discrepancies, duplicity of services, drug-seeking behaviors, missing records or undisclosed pre-existing conditions.

Here are some examples of successfully completed MRC, for reference: