Client Conversation
What is the first question after the client says they are discharged?
Ask if they are fully recovered or still have symptoms.
What form is used for hospital billing?
UB-04.
Completing 'Has Client Completed Treatment' changes status to what?
Demand Prep.
Name one common cause of delay in record requests.
Providers taking weeks or months to respond.
What determines whether a permanency letter is needed?
Attorney review.
Who completes the follow-up call after the Case Manager?
The attorney.
What do CPT codes represent?
Specific medical procedures.
How do you send medical requests to retrieval company?
Change status to ROT-Pickup.
What must be checked before assuming a provider is missing?
CPT codes on the lien/ledger.
What must injuries be connected to?
A reasonable degree of medical certainty.
When reviewing providers, what must be confirmed?
All facilities, treatments, testing, injections, and surgeries.
When can PCP/Ortho/PT final records be requested?
When the task says 'Request Final Records and Bills.'
What must be done weekly until received?
Follow-ups on Lost Wages.
Name one HIPAA-related issue.
Improper or outdated authorization.
When might a client have a permanent condition? (Give 1)
Surgery, tears, fractures, injections, neurological symptoms, etc.
What type of questions should be asked about daily activities?
Any challenges or disruptions caused by the injury.
What must be done if a provider has multiple doctors?
Confirm doctor name and location.
What tab requires detailed completion using CTRL+F?
Incident tab.
What could cause records to be incomplete?
Missing dates, wrong patient, or redacted info.
What guidelines are used for impairment rating?
AMA Guidelines.
When should scar photos be taken?
At 6 months.
What is the Medical Summary required to be sorted by?
Chronological order.
What must be selected under Final Treatment Analysis?
All procedures (MRI, CT, injections, surgery, etc.).
What type of provider is hardest to track down?
Third-party or out-of-state providers.
What must be compared to determine causal connection?
Pre-incident vs. post-incident ability.