On February 25, 2008, our Senior Records Clerk, Brandy, and her husband Jamie brought little Victoria to into our extended family! Congratulations all around!

Wake me when the lamb is served.

Our reputation for billing fairly is without stain and any implication that our practices are in congruity, in any way, with other so-called “IME providers� in this state is deeply offensive.  We adhere to the State of Washington, Department of Labor & Industries fee schedules and have done so from the first day of our practice.  We compensate our physicians at the highest rate of the pay scale and share our billings with them.  We do not hide our billing or compensation practices from our physicians or our referrals. 

The issues surrounding compensation for added time are still under review by the Department. Given the problems in the past with providers abusing added time fees, the Department took steps to rein in those abusers.  That does not mean that either the Department or any competent referral does not recognize that additional time is sometimes necessary in order to produce a thorough and competent report.  We have always billed, in quarter hour increments, an hourly fee based on the single examiner rate.  This adheres to prior use and policy and is a fair and equitable billing and compensation profile.

We consider that we are authorized by our referrals to take whatever time is necessary to complete the file review, history, examination, and report.  When we are able to anticipate in advance that additional time will be necessary (say, in the case of a very large file), we let the referral know immediately; however, advance warning for additional time cannot be provided in every case.   Sometimes a case takes more time, sometimes less.  Most experienced claims personnel recognize that it is not possible to calculate, in advance, exactly how much time a physician will need. They also know we will fairly tell them why added time was needed, what it was used for, and can rest assured the physicians were compensated for that additional time.

Our physicians are unable to calculate precisely how much time a patient examination or file review is going to take before an examination takes place.  To suggest that it is possible to do so flies in the face of understanding the competent practice of medicine.  Our physicians take precisely the amount of time necessary to do a thorough job and present an outstanding report.  Further, we do not presume to tell a physician how much time their work should take; we are neither trained nor qualified to do so.

Multi-examiner evaluations (true PANELS) are not some simple A doctor +B doctor +C doctor = opinion. You can’t throw three doctors together, or one after another, or have the patient seen in 3 locations and arrive at a true panel – a combined opinion. Our physicians are present while the history is being taken, present while the patient is being examined, and they then MEET to DISCUSS the case before any conclusions are reached.  This process is neither simple, fast, nor duplicable.  We are the only company in Washington whose physicians and staff have the ability to perform these complex tasks competently every time.  This approach is unique to Washington State; large national providers have no clue how combined opinions in Washington work.  It has taken our practice thirty years to hone the necessary skills in our physicians and staff to provide a combined opinion that reaches to every corner of the injury or condition under review.  

Our physicians have done this work to the same standards since 1978.  Our reports are outstanding and our reputation is unblemished. Whenever we spend additional time with a file, our physicians sign documents indicating why they have done so, and the time spent is verified by our staff and recorded into the report.  Our physicians are meticulous, exacting, and in every way outstanding as medical professionals and as people. They are incapable of falsifying such information and we are equally unable to countenance contemplating such behavior. 

If, for some reason, you do not find our standards of thoroughness worthy of compensation, we can only assert that your standards have been denigrated by other so-called “panels� in this state. Just because it has become acceptable with “IME providers� to have reports dummied up from forms filled out by the patient, have record reviews dictated and created by clerks, rewrite conclusions at the request of referrals, adjust conclusions so they fit together without consulting the physicians, and find it acceptable to schedule patients to be seen at a rate of between two and five an hour, does not mean that we do that here and we never will.

TPAs, legal offices, and self-insurers should wake up and look around — just because a report tells you what you want to hear and comes at a price that you want to pay makes it neither competent nor defensible.  These practices are why the process is in such (deservedly) profound disrepute.  It is the act of financially supporting such substandard enterprises that perpetuates their work and permits their ethically, medically, and legally corrupt operations to continue. To compare our practices in any way to theirs borders on slander. 
 
Ask yourself — why do the so-called “IME providers� have to bribe you with coffee cards in every report, or Mariners tickets, or other “perks� to get you to use their services? Because their work, like their marketing practices, are unable to stand on their own merits.

The implication that any of my physicians or I “pad� bills is a vicious calumny, supported in no way by our history or our actions. 

Many of the physicians who work for us will not work at other panels for a reason. The substandard medical and ethical practices of these providers revolts and frightens them. It should do to the same to you.

Peek-a-Boo Puppy

The Department is using the MedFX study to justify abandoning multiple examiner evaluations, yet the study offers no valid scientific or statistical data to support any of these actions.  Read the facts:

Econometric Evaluation of the MedFX Report

Econometric Evaluation of MedFX Report Appendix A

The full report on the “Project to Improve the Quality of Independent Medical Evaluations� by MedFX is available for review.

MedFx Study Chapter 1

MedFx Study Chapter 2

MedFx Study Chapter 3

MedFx Study Chapter 4

MedFx Study Appendix