The Medical-Legal Fee Schedule & Regulations Effective April 1, 2021, have caused increases in the cost of PQME/AME evaluations. The largest increase is the addition of the $3.00 per page record review charge for additional pages based on the type of evaluation or report being requested. Record review is currently be reimbursed at the following:
| Evaluation Type | Pages Included | Additional Fees | Average Record Review Increase* |
|---|---|---|---|
| Comprehensive Medical-Legal Evaluation | 200 pages of record review | $3.00 per additional page | $1,917 |
| Supplemental Medical-Legal Evaluation | 50 pages of records | $3.00 per additional page | $1,410 |
| Re-Evaluations within 18 Months | 200 pages of records | $3.00 per additional page | $1,437 |
| Sub Rosa Recording Review | Time spent reviewing sub rosa recordings | $81.25 for each 15-minute increment | Time Based |
*In July 2022 the California Workers' Compensation Institute found “Payments for medical-legal services used to resolve medical disputes over compensability issues in California work injury claims have risen sharply under the new Medical-Legal Fee Schedule.” HCRG Med Legal record preparation services are organized to assist organizations to cut down and manage this cost.
Our team of Workers’ Compensation experienced med legal and clinical staff will organize your claim file and medical records and have them ready for review while reducing your overall page count. We can also work with opposing parties, whether it be an applicant attorney or an in pro per applicant to expedite the process and enter into an agreement on which records to send.
Services include:
1) Scrubbing claim and medical records, remove all irrelevant documents and prepare for specific review.
2) Conduct a secondary review by a clinical team who will identify relevant medical records to include based on body parts or conditions being evaluated.
3) Prepare a Schedule of Records
4) Execute Labor Code 4062.3 Declaration
5) Calculation of number of pages
6) Complete other administrative tasks
Turnaround Time: 48-72 hours (excluding the 10 days for opposing party to object to records)
For additional information please contact Vicky Summogum, RN, MBA at 714-465-4352 or email info@hcrg.com.