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LNCtips.com: Medical Bill Analysis

Legal nurse consultants analyze and tally medical bills related to medical malpractice allegations to identy the Plaintiff's medical costs.  The Plaintiff usually contends that the costs occurred because of the malpractice.  LNC who are Life Care Planners also use medical bills to help project costs for the Plaintiff's future needs.

But identification of costs isn't the only reason to check medical bills. By reviewing medical bills, you can obtain other information about the case. Analysis of medical bills can help you to:

1) Obtain all dates of service for each provider. By comparing the billing dates of service to the provider's medical records, it can help you determine if you have a complete set of medical records from the provider. If you have bills but no records for all the dates of service, your records for that provider are incomplete.

2) Ensure that you have a complete set of medical records for each date of service. In this case, you have bills for each date of service but you lack records for some things that were billed. For example, you may find that the patient was billed for x-rays, lab work, or EKGs that are not in the medical records.

3) Identify all insurance companies in the bills. Medical records usually identify the name of the insurance company but sometimes the information is out of date. Billing records will almost always identify the name of the patient's insurance company unless the patient is self-pay. In turn, insurance company records may give you with the names of more providers.

4) Identify treater names. With large multi-speciality groups and large pediatric providers, it's not uncommon for non-primary physicians to treat their associates' patients on an on-call or triage basis. The billing records usually identify the physicians and which date they saw the patient.

5) Determine diagnosis codes. Sometimes the physician's handwriting is so bad that it's hard to identify anything about the nature of an office visit. Most bills list a diagnosis or at least a diagnosis code number. After identifying the diagnosis code using Google or another search engine, you can go back to the medical records and try to match the diagnosis to the handwriting. If you can't, at least you can tell the attorney the diagnosis for the visit.

In addition to identifying costs, you now know how to analyze medical bills to obtain more information about the case.

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...Katy Jones