PI Process 101
What must we have on file before working on a case?
Signed Retainer Agreement
What kind of injury is a herniated disc?
Spinal/Disc Injury
What should you never include in a call to the insurance carrier?
Liability Opinions
Who do we send 768 letters to?
Health insurance companies
What’s the 2-minute rule?
If a task takes <2 mins, do it immediately
What phase involves gathering insurance info and sending LORs?
Pending Client
Which provider treats TBIs?
Neurologist
When should the LOR be sent?
The same day the claim is filed.
What info do we need from the client to send a 768 letter?
What system must intake notes and follow-ups be logged into?
Prevail
What comes after demand if no agreement is reached?
Litigation
Why is a gap in treatment over 2 weeks bad for a case?
It lowers case value.
Name one common mistake when filing a claim.
Not confirming adjuster contact information
What’s a major risk of missing a Medicare lien?
The client can lose their Medicare benefits.
What is it called when you match a group of similar tasks together to boost productivity?
Task batching
What is one reason why strong intake helps case value?
Good intake leads to faster setup and higher settlement success
What imaging is used for clients who can’t have an MRI?
CT Scan
What 3 pieces of information must be included in an LOR?
Client name, date of accident, and statement of representation
What’s one key difference between where we send 768 letters vs. medical records requests?
768 letters go to health insurers, NOT providers
What’s one tip for maximizing follow-up success during the first 2 days of contact?
Use multi-channel outreach: call, text, and email
Name one red flag that must be escalated during intake.
Client already has an attorney, admitted fault, or serious pre-existing condition
A client mentions “radiating pain” and “tingling” — what kind of injury could this be and which specialist would likely treat it?
Disc injury or nerve issue; referred to Orthopedic or Neurologist
What is the insurance company’s deadline to provide policy/coverage information after receiving the LOR?
30 days
What’s the name of the system Medicare uses for lien verification and tracking?
CMS Portal
Name 2 high-performer habits from the guide that help prevent missed leads.
Contact new leads within 15 minutes; start each day checking what’s pending/urgent