NuQuest offers a complete and innovative suite of pre- and post-settlement solution services. Our expert team of registered nurses, workers’ compensation and liability claims adjusters, professional administrators and specialized legal counsel are ready to work with you to ensure your Medicare Secondary Payer (MSP) Compliance requirements are completely fulfilled to your greatest advantage – NuQuest delivers maximum savings.
The NuQuest file review service provides research, review and analysis of the medical and billing files related to a claim. This service yields a report that includes the comments and recommendations of a legal nurse consultant and can range from simple to complex. Service may include review of an injured person’s medical records, payment history and bills for medical causation and relatedness to a specific event, identification of co-morbid factors, utilization, and the accuracy of billing.
This service can range from complex to simple:
- Complete medical records and bill review includes a detailed review of an injured person’s medical records, payment history and bills. It provides a comprehensive report that addresses causal relationship and relatedness to a specific event; identification of any co-morbid factors; utilization; and the accuracy of billing. It includes comments regarding the delivery of reasonable, necessary and appropriate medical care.
- Complete medical record review provides the same services as above, but excludes review of an individual’s payment history and bills.
- Limited file review includes a file review and report that is limited to specific, identified records to determine their relatedness to the case, along with a determination of the reasonableness, necessity and appropriateness of the medical care in a defined circumstance.
- Medical bill review and analysis includes a file review and report that focuses on an injured person’s medical bills – to determine appropriate coding, charges, duplication of services and relatedness to a specific event.
- Bill audit includes a more comprehensive evaluation (which may include an on-site review), to analyze the accuracy of charges by comparing them with actual medical records and other documentation of services. The bill audit report includes recommendations regarding disposition of any unsupported charges.
Legal Nurse Consulting Services
All NuQuest nurses are sustaining members of the American Association of Legal Nurse Consultants. The services provided by these nurses include: screening of cases for merit and deviation from applicable standards of care; extensive file review with preparation of a medical summary or chronology; medical literature research; identification of and consultation with medical experts; interviews with clients and witnesses; assistance with the discovery process; and all other aspects of preparation of the medical aspects of a case for litigation.
Medical Case Management
The NuQuest medical case management service focuses on comprehensive (rather than limited) implementation of the recommendations included in an injured person’s life care plan. Case management includes (but is not limited to) assessment, planning, coordination and delivery of the wide range of services outlined in a life care plan.
The medical settlement planning process works best when everyone involved understands how myriad parts work together to produce an optimal outcome for all parties. NuQuest experts – medical, benefits and legal – focus all of their professional attention on this highly specialized field. We are able to provide training and consultation services to claimants, plaintiffs, defense and plaintiff attorneys, structured settlement brokers, fiduciaries, workers’ compensation insurance carriers, property and casualty insurance carriers, self-insured entities – and anyone else involved in this process.