Preparing for PI patients

3 simple steps to get your office ready for personal injury clients.

Being prepared for a new personal injury (PI) patient takes conscious effort, critical planning and a proactive mindset. Failing to look ahead leaves you vulnerable, as you’ll be an easy target for a gamut of errors and omissions. In addition, preparation will decrease your personal risk and practice liability, increase your confidence, and improve your documentation and case management.

In today’s PI environment, nearly every case is closely monitored by insurance carriers and medico-legal professionals. Making inadvertent clinical and nonclinical mistakes can lead to major consequences such as diminishing your professional reputation and increasing the risk of financial concerns, malpractice claims, board complaints, and insurance investigations.

Three simple steps can immediately improve your preparation for the next PI patient who comes through your practice.

Step 1: Develop a script

Once your receptionist has identified a caller as a patient injured in an accident, your staff can immediately initiate the process of gathering accident-related information if you have a detailed phone script.

With PI cases, your script should prompt the patient to provide his or her legal name—no nicknames, initials, or abbreviations. The task seems simple enough, but it’s embarrassing for you when information is requested from your office and you have inaccurate or incomplete documentation.

Your script should also include a detailed list of information and materials needed from the patient. This will help you assess the specific type of PI case and clinically evaluate the patient’s injuries. Your front-desk staff should instruct all new PI patients on what to bring for their first visit.

Always require some form of photo ID. In many instances, providers—especially in these types of cases—have treated wrong or fraudulent patients. Even just one such scenario can lead to grave consequences.

Next, gather and document any photographs of the patient’s injuries and property damage. These are essential in visualizing the situation, assessing the mechanism of trauma, and determining the severity of the impact. All photo evidence will influence your causation statement.

Have your PI patients provide as much third-party and health insurance information as possible. If you’re dealing with a car accident case, the patient should bring a copy of his or her automobile insurance policy.

The declaration page will list the coverage purchased, such as PIP, uninsured motorist (UM), and underinsured motorist (UIM) coverage. This information will be important when making your co-management decisions or if you have to negotiate your services billed at the time of settlement with the third-party carrier or an attorney.

Your staff may encounter resistance from patients or the representing attorney when requesting insurance information, especially when the accident was not the client’s fault.

Patients may say something like, “I want the third-party (at fault) insurance to pay for everything,” and balk about providing their insurance documents. But without a clear analysis of all insurance information (first and third party), you severely handicap your decision regarding the viability and collectability of the case.

Additional information to request may include but is not limited to:

• Police and incident reports, and
• Post-accident medical records, including any diagnostic tests and imaging results.

Step 2: Streamline the paperwork

Set up a system that allows patients to fill out paperwork in advance of their scheduled appointment. An office website with the capacity to upload forms and documents is one possibility.

An alternative is to create a file folder on the main computer at your front desk. Place all the necessary forms in the file, then send them ad hoc by email or fax. Documents might include patient intake, outcome assessments, PI-specific forms, office policies, and HIPAA agreements.

The advantages of having paperwork filled out ahead of time are many. First, new trauma patients might be in a significant amount of pain from their injuries. If greeted at your office with a stack of paperwork, many patients would be frustrated and want to speed through the process to see the doctor. This may lead to inaccuracies, inconsistencies, and omissions, which will be problematic for you and the representing counsel.

Adverse carriers will be scrutinizing your records in attempt to dodge or diminish your reimbursement and cast reasonable doubt on your patient’s alleged injuries and treatment. You don’t want to give them any wiggle room.

Another reason is to save time. If patients take longer than expected to complete the documents, it will cause you to run behind in your treatment schedule. When you’re rushed, you might start taking clinical shortcuts to catch up. In a hurry, you’re apt to shorten your initial history or examination procedures or delay necessary diagnostic imaging.

Your first evaluation of an acute-trauma PI patient is not the time or place to cut corners. Trauma patients pose an inherently greater risk and liability to your practice, and this will only increase your exposure.

By allowing patients to complete the process in the comfort of their own home, you increase their chances of accuracy and give them opportunity to access legal and other materials they may not remember to bring to your office.

Step 3: Oversee training

To guarantee consistency among employees in their treatment of PI patients, implement a staff training system. Many procedures, including the initial phone call, explanation of office forms, and answering technical insurance questions are generally performed by office staff. A well- trained team is your safety net.

Constantly review your PI procedures in detail from beginning to end. Develop checklists for all responsibilities to ensure everyone is accurate, thorough, and accountable. Holding regular staff meetings devoted specifically to PI will increase office productivity, hasten implementation, improve medico-legal communication, and mitigate your liability.

When it comes to your PI patients, avoid critical mistakes. Protect your practice and your bottom line by taking the time to be proactive and prepared.

 

SCOTT TAUBER, DC, DABCO, CPC, is the COO and lead instructor for the American Institute of Personal Injury Physicians (AIPIP). AIPIP trains physicians of all specialties to improve, protect, expand, and market their PI practices. Tauber is a diplomate of the American Board of Chiropractic Orthopedists and a certified professional coder. He can be contacted at 888-924-7479 or scott@aipip.com