Just completed evaluating a medical claim in a tort case. The claim, amounting to $24K, involved one hundred and seven listed services. Interestingly, the insurance carrier’s report included services dating back six years before the injury, resulting in a significant reduction of the claim to under four thousand dollars. It’s crucial to pay close attention to the dates of service in such cases.
Linkedin hashtags: #MedicalClaim #Insurance #TortCase
More will follow on this topic. Each week will highlight an important area for accurately valuing a medical claim.
Use the free price checker for a claim you are now examining and learn what an individual service is worth. Type in the CPT code and the amount charged. You will see the fair market value and the overcharge.
This is what your report will look like:
The valuation logic is based on “fair market value” as defined in Treasury Regulation §20.2031-1(b).
