Mistakes To Avoid

When the doctor and attorney do not use correct terminology and format, broken down into Value Drivers and if these liability drivers are not addressed, there is up to a 20% reduction of settlement value. 

For Lawyers
1). Claims Software
Know the specific Claims, Practice & Procedure Software type the insurance company uses and the protocol it contains to evaluate the claim in order to create the advantage.

2). Treatment Software
Know the Treatment Acceptance & Payment Software type the specific insurance company uses to evaluate treatment and doctors fees so the entire medical bill can get paid and not have to come out of the patients pocket or settlement dollars.

3). Validating Letter
Submit a 9 Point Medical Position Validating Letter.

4). Liability Drivers
Present the 19 Liability Drivers in representing claims to increase settlement offers.

5). Value Drivers
Know and use the Value Drivers for up to a 20% higher settlement offer.  

For Doctors
1). Loss of Duties Under Duress 
The effects accident injuries on activities of daily life (loss of “Duties Under Duress”  and “Loss Of Enjoyment”), are parameters that respond to an additional settlement value that is available but not accessible to the public. Doctors must evaluate the patient accordingly and utilize 2 special forms; "Duties Under Duress" and "Loss Of Enjoyment".

Failing to use the prescribed worksheet and forms to document loss of “Duties Under Duress”  and “Loss Of Enjoyment” that responds to the additional value, can cost 85% of a settlement offer by completing these worksheets and forms. 

2). Supplemental Diagnoses
Failure of a doctor to use a Supplemental HCFA form can lower the value of a claim by 50%. The form is available on line and allows for double digit (over 20) diagnoses. The standard form (most doctors use) only allows 4 diagnoses. 

3). Whiplash?
Avoid the use of terminology that references Whiplash or Soft Tissue Damage. These words actually lower the settlement offer. 

4). Body Part, System, Organ or Function
Make sure every injury has been diagnosed by body part not region part.

 5). Case Format Work-up
Make sure every individual body part injury is worked up in the same format used by the patients particular insurance company. Know the Treatment Acceptance And Payment Software and the Claims, Practice & Procedure Softwarethe insurance company uses and work the case within those given parameters.

 6). Terminology
Use specific terminology to ensure that any required future treatment, in both active and passive capacity, will be accepted and supports the payment of your medical bills as well as supporting the evaluation of the injured claim.

 7). Maximum Medical Improvement (MMI) 
If each body part as well as correct use of MMI is used in the representation of the claim, the manifestations which drive general damages can then be defined and included in the insurance evaluation of the claim and reflect special damages, disabilities and/or the manifestation of economic loss or opportunities of specific factors of duties under duressor pain & suffering or loss of enjoyment.

8). Medical Costs 
Make sure all treatment costs are accepted by the insurance industry by knowing the particular Treatment Acceptance & Payment Software the patients' insurance company uses and working the case within its parameters.

9). Diagnosis
Avoid the use of the words “Whiplash” or “Soft Tissue Damage” which can devalue the claim. Use of the Supplemental HCFA Diagnosis form and double digit diagnoses (over 20) can increase settlement offers by 50%.

For The Doctors
1). Selection of Physician and Attorney
You now realize that to attain the highest settlement offer, BOTH your physician and attorney need to be trained in the protocol contained and represented in this web site. 

There is no level playing field for doctors or attorneys to get info on all these programs with one exception. Such tutorial continuing educational symposiums are being conducted nationwide to instruct both doctors and atorneys. If you are a physician or attorney, contact us for dates and locations of our national symposiums scheduled now through the end of 2012. 

The accumulation of the specific data we discussed within this website, in the correct terminology & format, translates into severity points in the insurance industry, which then translate into dollars based on each insurer’s rate or formula.  

You could accrue 3,000 severity points which may only equate to 250 settlement dollars. This process is so detailed & complex that the public must rely upon only those doctors and attorneys that are educated in this environment. To do otherwise would give back large portions of your settlement to the insurance industry & leave large amounts of dollars that were already determined to be paid in the settlement had you only used the properly trained medical & legal experts.

National Colossus Seminars

CAPSULE SUMMARY and a valued difference of a claim being worth 4 or 5 times what is being offered.

Knowing the Treatment Acceptance & Payment Software and Claims and Practice & Procedure Software type the insurance companies use, submitting the correct forms as; Supplemental HCFA form, Duties Under Duress form, Loss Of Enjoyment form, representing all the components to evaluate the claim as; Value Drivers, Liability Drivers, Medical Position Validating Letter, and often times simply stating what is medically evident or factual in the correct terminology and format will be the significant difference in that claim receiving full payment for medical treatment received and a valued difference of a claim being worth 4 or 5 times what is being offered. 

Protect yourself and support those physicians and attorneys who have taken their time to train in these procedures to best represent you and arrive at the highest settlement offer.