Four C’s you should consider to improve handling of your auto claims.
Improve how you handle Injuries by determining:
Caused - What injuries were caused by the accident?
Accident severity - classify into familiar categories - high/severe, medium/moderate, low/mild.
Injury severity - classify into familiar categories - sprain/strain, fractures, tears, disc, concussion or severe, moderate, mild.
Position - document location and posture within the car.
Restraints - determine if seatbelts were engaged properly.
Airbags - determine if airbags deployed.
Consistent - Can you classify pain?
Nerve pain - common descriptors include burning, tingling, pins and needles, shooting and numbness, prickling, and shock-like. This pain can be constant or triggered.
Soft tissue pain - damage to joints, muscles, skin, tendons, and bones commonly described as sharp, aching, or throbbing.
Radicular or nerve root pain - often travels from one area of the body to another. It is often described as pinching, numbness, and tingling, with or without muscle weakness.
Acute pain - typically described as sharp, intense, throbbing, and localized to the area of the injury, often accompanied by bruising or swelling.
Chronic pain - typically described as a dull pain, ache, stiff, restricted movement.
Pain referral - determine if the pain local to a specific area or does it travel.
Pain pattern - what aggravates and eases pain.
Cared for - Is the treatment helpful/appropriate?
Conservative vs invasive treatment - the majority of low, mild, and even moderately severe accidents can have significant improvement with conservative treatment ie Physical Therapy, or Chiropractic care vs injections or surgeries.
Active vs passive - look for a greater focus on mobilizations, home exercise, therapeutic movement, and stretching vs a focus on hot packs, electrotherapy.
Progression (treatment and the individual) - patient progression would be increased tolerance, decreased pain intensity and frequency, localizing of symptoms, increased strength, and range of motion.
Cost
Is the bill related to the treatment and the caused injury - compare the ICD to CPT codes to make sure they align.
Is the bill appropriate - compare the billing to the appropriate review of the claim for example (PPO, Usual and customary, medicare, and state fee schedules).
It may seem daunting or time-consuming to take these steps, but technology makes this information easily accessible and can streamline many of these considerations. Find out how technology can help you with your claims by contacting a Talem expert today.
