What To Consider When Choosing a Medico-Legal Provider

Choosing a medico-legal provider is fundamental whether it be for a personal injury, worker’s compensation or medical negligence case. This choice represents the backbone that supports the referral; from choosing the right medico-legal expert, to receiving a report which represents value and helps you progress the case, everything starts with your choice of provider.

With so many providers, how do you know who will provide the best possible service? Here are eight things to consider when choosing a medico-legal provider.

Reputation and experience 

Medico-legal providers on the surface, offer very similar services, with the mainstream service being access to independent medical examiners. However, like most services there are differentiating aspects relating to how they deliver these services and the standards which they strive for. 

When considering a medico-legal provider one should be curious about who they are entrusting with the referral – here are some questions or areas of interest that may help in selecting the right provider for you and your client:

• Information pertaining to the ownership or management structure of the business
• Collective experience of management team
• Business Values, Purpose and Culture
• What is the process of making a booking?
• What is the pricing structure?
• What are your services?
• What are the timeframes of receiving the referral brief?
• How are the medico-legal reports quality assured?
• What are your report turnaround times?
• How are medical specialists selected for the referral network or panel?
• Are the medical experts open to feedback and is there a process in place for continuous improvement?
• What professional development, accreditation and training do the medical experts require to provide medico-legal services?
• How do you secure private and confidential information?
• Do you have any value-add services?
• What is the breakdown of referrals across client types?
• Do you have any client testimonials?
• Will there be a designated account manager or point of contact for enquiries?

Range of services

Asking about a provider’s range of services can often help to reduce time ringing around trying to find what you need across multiple providers. More often than not, you will likely find that most medico-legal providers provide standard independent medical examinations which are delivered in-person, virtually or by desktop (file review).

From a Red Health perspective, we pride ourselves on being innovatively minded, and have developed a range of industry-first services. A couple of these being our Red Asses Plus (IME Plus) and MAS Service. Our focus is on delivering value to our clients and these two new-to-the-market products represent this.

Responsiveness and turnaround times

Expectations around the delivery of timely and efficient services are at an all time high; particularly when you consider the type of clients that require medico-legal services. Timeframes relating to the management of a case can be strict in an environment known to have competing priorities on a daily basis. 

Having a medico-legal provider who can offer appointment availability when you need it and issues a report within your required timeframes, helps support the overarching process which referring clients adhere to, and can reduce expenses incurred from delays.

Communication is a crucial component and a step that a medico-legal provider should take to keep its referring client informed – particularly if a delay may be expected. There is nothing worse than being left in the dark and having to be reactive at last minute.

Quality assurance

Medico-legal providers must have a robust quality assurance process to help support medical experts with their reporting efforts. Think peer review, regular feedback, independent auditing, and ongoing professional development to ensure reporting remains accurate, impartial, and in alignment with legislative and scheme requirements.

At Red Health, we’re proud to say that our quality assurance is conducted in-house by a dedicated team who take a personalise approach when working with our medical experts and clients.  

Cost-effectiveness

A medico-legal provider should be able to offer pricing transparency so you are not faced with bill shock. Some providers are known to have hidden fees which are only made known after the service has been completed and in some cases, will withhold the report until payment is made. 

Ask about whether the fee includes things like an impairment calculation or the completion of a form, and what their cancellation policy is. You may also benefit from knowing whether prepayment is required, or if the provider can defer the fee for you and your client. 

A provider should be comfortable in giving clear information in writing and if they’re not, then this may be a reason to make further enquiries before making a referral. 

Support and guidance

If you’re unsure which services are required for your case, is there support and guidance available to answer your questions and discuss the options available? 

If so, what does that look like and will a cost be involved?

Red Health provides a complimentary advisory service through its Client Services Team and can be accessed here

Experts at their fingertips

Size does not always matter when it comes to how many experts sit in a referral network or on a panel. It comes down to the quality and reputation of the medical expert and their level of commitment to delivering their service to the medico-legal provider, and subsequently the referring client. 

The majority of referrals for medico-legal opinion go to about 10-12 medical disciplines if you consider the bulk of claims being related to personal injury. Red Health’s referral network offers roughly forty disciplines as we have a diverse client base and cover many claim types. 

The main areas for consideration when selecting a medico-legal provider to work with shouldn’t necessary be how many experts they have in total, but rather what experts do they have that align to your claim needs, what is the wait time for appointments, what is the turnaround time of reports, what is their medico-legal experience and what are they like to work with.

Assessment flexibility 

These days flexibility isn’t a perk, it is an expectation!

Offering a range of delivery methods is instrumental in ensuring that delays and stress can be avoided. Most medico-legal providers will offer face-to-face and virtual options for the delivery of independent medical assessments but it is important to understand that each provider will approach things differently and this is where quality comes into things.

For example, with virtual assessments, understanding how this is setup and conducted is vital as some providers will utilise a surrogate practitioner, and others will not. For those that do use a surrogate practitioner, do they have a standard approach where they only use allied health professionals or an alternative? Where no surrogate is used – what steps are taken to valid physical findings or as evidence to support the medical opinion?

Red Health is all about quality and we will never jeopardise this. We offer a range of services that can be delivered in-person, or by virtual / hybrid means. We always use registered and experienced allied health professionals for our virtual assessments where physical testing is required. We take care of all steps involved including arranging surrogate practitioners, consulting rooms and testing the virtual connection prior to the appointment.

For Red Health, our core values aren’t simply words on our website; it’s how we do business. By choosing Red Health, you’re selecting the people’s provider putting human centered-care back into the medico-legal industry.