9 Surprising Key Questions to Ask Before Selecting a Doctor
When You’ve Just Been in an Auto Accident
This is information you could use or money you could lose.
If you’ve just been in an auto accident, you should know not all doctors are the same when it comes to handling injury claims. Your injury claim can be subject to a loss by up to 80% if your doctor fails to perform your injury assessment correctly. Here are 9 surprising key questions to ask before selecting your doctor so you get the care you need and get all the money you deserve.
1. How many sections do you include in your evaluation of an injury claim?
You want to hear 26. An auto accident injury doctor should know and record 26 vital and different sections when performing an injury model assessment. Missing areas will translate into missing settlement valuation.
2. What CPT-Code Level Examination Do You Use?
- 99204 (Medicare) or
- 1191M Injury Model?
They may look like meaningless numbers to you, but the only answer you should accept is 1191M Injury Model. It is important that your auto accident injury doctor is trained to perform the 1191M Injury Model Examination on an accident claim or many factors that determine settlement valuation will be lost.
3. Do you rate these 5 areas?
- Whole Person Impairments?
- Specific Disorders of the Spine?
- DRE Categories
- Spine Impairment Summary
- Injury Severity Types & Trauma Lines
Make sure the answer is yes, all five. While it isn’t vital you understand all these terms, it is vital that your accident injury doctor is trained to perform and include all the above data in your injury assessment. It is reported that Colossus will discount the medical settlement valuation by 25% if the above data is missing.
4. Do you use questionnaires to determine ligament damage, mild traumatic brain injuries & concussions, post-traumatic stress disorders, cervical chain ganglia injuries?
You want to hear yes. There are over 100 questions that should be part of the injury assessment, and AMA Guides criteria that need to be asked to identify whether any of the above injuries exist. As you can imagine, that’s a lot to remember. Your auto accident injury doctor should use a questionnaire to be sure all the correct questions get answers. Without it, your injuries could be missed or you could be leaving insurance money on the table.
You’re looking for yes. It’s one thing to gather information; it’s another to display it. Insurers have created Business Process Improvement allegedly to improve their ability to evaluate injuries. This requires auto accident injury doctors to submit a table showing each body part involved, citing the AMA Guide utilized in the assessment, and listing the chapter, table and page to reference that the exam was done according to AM Guides.
Our team at the Health Institute of Western Colorado are experts in treating auto accident injuries. But don’t take our word for it.
6. How many diagnoses do you tender in an injury claim?
The answer you want is 10. In an injury model, insurers look for ten different diagnoses to fully represent the effects of the accident. If the doctor is trained in the Injury Model Assessment he or she will be able to identify all the 10+ injuries normally seen in soft tissue cases.
7. Do you give a general prognosis or a different prognosis for each body part involved?
The answer you need is different. Most doctors are trained to tender a general prognosis, however, to represent an injury claim; a different prognosis is required for each diagnosis.
8. Do you assign each injury a stable and static diagnosis?
The answer should be yes. Injuries occur to different parts of the body and can include emotional factors as well. See our website for a listing of some of the injuries that occur and the nasty consequences of misdiagnosis. Insurers ask when each injury will be STATIC, or when there is no longer a need for treatment, versus injuries requiring more care, known as STABLE injuries.
9. Do you send the completed medical file to an independent, medical, 3rd party examiner to validate your medical assessment and show that your findings meet evidence-based burdens of proof?
The answer you need is yes. When an insurance company disputes the findings of your auto accident injury doctor, the court can call for a second medical opinion. This can delay your treatment, waste your time, and reduce the settlement money you need. The Independent Medical Validation (IMV) is an independent, third party examination to ensure your injury assesment is properly completed. Your doctor should be referring your completed file for this court-approved assessment or you will not be able to successfully defend against the insurance company’s disputes.