EPISODE DESCRIPTION

Here are the notes summarizing the key points discussed:
– Be cautious when working with larger QME (Qualified Medical Evaluator) companies
– Get the injured worker’s history yourself, don’t rely solely on the company
– Watch out for high cancellation rates where the company still gets paid but you wasted time
– Avoid companies that spread you thin across multiple locations with low patient volume
– Ensure the company provides adequate support tools like templates and scribes
– Prioritize quality of service over convenience or reputation when selecting a QME company
– Accurately assess the injured worker’s impairment level
– Difficulties tracking down records and communicating with various parties
– Impact of private equity ownership on case opportunities
– Risks of delays or errors in reporting process
– Need for attention to detail, timely and high-quality reporting, effective quality assurance

KEY LESSONS

The 3 key learnings that are likely surprising to the reader are:
• QMEs face significant challenges in the workers’ compensation system, including the need to conduct thorough patient evaluations, maintain accurate records, and adhere to industry guidelines.
• Relying on QME companies that provide inadequate support, such as poor record summaries, limited scheduling flexibility, and lack of comprehensive exam templates, can be detrimental to the quality of QME reports.
• QMEs need to be proactive in managing their practices and advocating for their interests within the complex workers’ compensation landscape.

CHAPTERS

00:00 Navigating the Pitfalls of QME Companies
02:56 Pitfalls of QME Reports: Lack of Comprehensive Listings, Inefficient Documentation, and
Inadequate Quality Assurance
04:15 The Importance of Details in Workers’ Compensation Cases
06:01 Challenges in Evaluating Injured Workers
07:31 Navigating QME Challenges: Timely Reporting and Records Review
09:09 Concerns with QME Practices and Recommendations
11:30 Delegation in Medical Reporting
13:10 Challenges of a Practice Coordinator
14:58 Importance of Proper Spine Evaluation and Report Writing for QMEs
17:44 Differences in Physician-Attorney Interactions for SIBTF Cases
19:13 Importance of Standardized Reporting Templates

SUMMARY

The speaker discusses the traps and pitfalls to be aware of when working with larger QME (Qualified Medical Evaluator) companies. They emphasize the importance of getting the history
from the injured worker yourself, rather than relying on the company to do it. They also caution against high cancellation rates, where the company still gets paid but the physician has wasted
time and effort. Additionally, the speaker warns against companies that spread physicians across multiple locations with low patient volume, and those that don’t provide adequate support
tools like templates and scribes to streamline the reporting process. The key message is to be cautious when selecting a QME company and to prioritize quality of service over convenience or
reputation. The speakers discuss the challenges and complexities involved in workers’ compensation cases from the perspective of a physician. Key points include the importance of
accurately assessing the injured worker’s impairment, the difficulties in tracking down records and communicating with various parties, the impact of private equity ownership on case
opportunities, and the risks of delays or errors in the reporting process. The speakers emphasize the need for attention to detail, timely and high-quality reporting, and effective quality
assurance to navigate these challenges successfully. The speaker discusses several challenges faced by QMEs (Qualified Medical Evaluators) in the workers’ compensation system.

Key points include:
– Delays in receiving medical records can force QMEs to review them again after seeing the patient, limiting their ability to ask follow-up questions.
– Some QME companies fail to provide timely patient histories, forcing QMEs to waste time waiting or work without crucial information.
– Unclear or excessive medical records can distract QMEs from the most relevant details of a case.
– The use of “ghostwriters” to draft QME reports is a concerning practice that can undermine the QME’s familiarity with the case and the AMA Guides. The speakers discuss the challenges that
non-physician medical evaluators face when working with Qualified Medical Evaluators (QMEs) in the workers’ compensation system. They highlight issues such as poor record summarization,
lack of scheduling flexibility, absence of travel stipends, and inadequate training on how to properly write evaluation reports. The speakers emphasize the need for QME companies to better support their providers and ensure they are equipped to deliver high-quality assessments that withstand scrutiny from attorneys and other stakeholders. The speaker, a physician, discusses the challenges and considerations around working as a Qualified Medical Evaluator (QME) in the workers’ compensation system. They highlight issues such as QME companies not informing physicians about “hot markets” where they can see more patients, the reluctance of practice managers to request tele-evaluations due to increased workload, and the higher financial payouts for SIBTF (Subsequent Injuries Benefits Trust Fund) cases compared to standard QME work. The speaker also criticizes the lack of effective reminder systems and comprehensive physical exam templates provided by some QME companies, which can make the job more difficult. Overall, the speaker advocates for physicians to be more proactive in managing their schedules and advocating for their interests within the QME system. The speakers discuss the importance of following proper procedures when writing medical reports, particularly when using standardized templates. They emphasize the need to conduct thorough physical exams and be familiar with industry guidelines, such as the AMA guides, to avoid having reports rejected. The speakers also recommend using cloud-based systems to ensure reports are always up-to-date and accessible to all relevant parties, rather than relying on local storage. The key points are the importance of adhering to protocols, being knowledgeable about industry standards, and utilizing cloud-based solutions for efficient report management.