Why Roll The Dice?

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How to win every soft-tissue injury claim.

You win when you walk away from a case just as well as why you aggressively pursue the maximum outcome.

Information about the injury outcome value gives you the leverage every time.

With the information you have, the carrier will never let out of discovery.
They will settle knowing they would not throw the dice against the information you have.

It is there for all to see, we just patented a process that gets it to you faster and easier to read.
ou want to hope for litigation.

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Why Roll The Dice?

  1. 1. Don’t Roll the Dice Copyright 2011 – eMetrex LLC
  2. 2. How to Win Every Claim Copyright 2011 – eMetrex LLC Every Time
  3. 3. <ul><li>Bio-mechanics of a </li></ul><ul><li>Soft-tissue injury </li></ul>
  4. 4. <ul><li>Usually, when a ligament or muscle of a moving joint is injured , the normal range of motion (ROM) is initially diminished in proportion to the severity of the injury. </li></ul>
  5. 5. <ul><li>Every moving joint has a Range of Motion (ROM) that is measured in degrees from the neutral range . </li></ul>
  6. 6. <ul><li>These measurements are also known as findings and </li></ul><ul><li>Documented in the medical records as objective evidence of treatment </li></ul>
  7. 7. <ul><li>These measurements are also known as findings and </li></ul><ul><ul><li>Documented in the medical records as objective evidence of treatment </li></ul></ul><ul><ul><li>Objectively Quantifies soft-tissue injury recovery, stability or deficit disability. </li></ul></ul>
  8. 8. <ul><li>In the claims world: </li></ul><ul><li>The Carrier will try to use medical consultants to mitigate their potential claims loss. </li></ul>
  9. 9. <ul><li>In the claims world: </li></ul><ul><li>The Carrier will try to use medical consultants to mitigate their potential claims loss. </li></ul><ul><li>The legal side will pay their medical consultants to counter the carrier’s consultants. </li></ul>
  10. 10. <ul><li>In the claims world: </li></ul><ul><li>The Carrier will try to use medical consultants to mitigate their potential claims loss. </li></ul><ul><li>The legal side will pay their medical consultants to counter the carrier’s consultants. </li></ul>A costly, unnecessary and time consuming process!
  11. 11. <ul><li>Why not use the evidence documented by the treating providers in the claim file? </li></ul><ul><li>The objective findings of the joint range of motion are the most powerful evidence of injury or stability. </li></ul>
  12. 12. <ul><li>Individually, those numbers are objective evidence of: </li></ul><ul><ul><li>The provider’s efficacy of treatment. </li></ul></ul>
  13. 13. <ul><li>Individually, those numbers are objective evidence of: </li></ul><ul><ul><li>The provider’s efficacy of treatment. </li></ul></ul><ul><ul><li>Your client's muscle motion </li></ul></ul>
  14. 14. <ul><li>Individually, those numbers are objective evidence of: </li></ul><ul><ul><li>The provider’s efficacy of treatment. </li></ul></ul><ul><ul><li>Your client's muscle motion recovery or deficit. </li></ul></ul><ul><ul><li>The Point of Maximum Improvement </li></ul></ul>
  15. 15. <ul><li>Individually, those numbers are objective evidence of: </li></ul><ul><ul><li>The provider’s efficacy of treatment. </li></ul></ul><ul><ul><li>Your client's muscle motion recovery or deficit. </li></ul></ul><ul><ul><li>The Point of Maximum Improvement </li></ul></ul><ul><ul><li>Can disclose fraudulent behaviors </li></ul></ul>
  16. 16. <ul><li>Cumulatively, those numbers produce your OPM Screen ™ to insure you will never have to roll the dice. </li></ul><ul><li>You will possess the injury facts as documented by the treating providers. </li></ul>
  17. 17. What is OPM? <ul><li>The documented Range of Motion changes of a soft-tissue injury by the treating medical providers from the beginning of the claim. </li></ul><ul><li>AKA = Objective Evidence . </li></ul>O bjective P erformance M etrics
  18. 18. What is Objective Evidence? <ul><li>The documented Range of Motion measurements that verifies the efficacy of treatment </li></ul>Objective Evidence
  19. 19. What is Subjective Opinion ? <ul><li>The third party opinion of the status of medical recovery based on a one-time examination. </li></ul><ul><li>Used by carriers and attorneys to claim and counter claim special damages. </li></ul>Subjective Statements
  20. 20. What’s the differance? <ul><li>Objective Evidence </li></ul><ul><li>Subjective Opinion </li></ul>
  21. 21. What’s the differance? <ul><li>Objective Evidence </li></ul><ul><ul><li>Measurements of the patient’s injury ROM that can be immediately and independently verified . </li></ul></ul><ul><li>Subjective Opinion </li></ul><ul><ul><li>Non-quantitative information that is not verifiable at any time. </li></ul></ul>
  22. 22. What’s the differance? <ul><li>Objective Evidence </li></ul><ul><ul><li>Measurements of the patient’s injury ROM that can be immediately and independently verified . </li></ul></ul><ul><ul><li>“ Cervical Flexion is 60 ˚ today” </li></ul></ul><ul><li>Subjective Opinion </li></ul><ul><ul><li>Non-quantitative information that is not verifiable at any time. </li></ul></ul><ul><ul><li>“ Pt states his neck still hurts.” </li></ul></ul>
  23. 23. What’s the differance? <ul><li>Objective Evidence </li></ul><ul><ul><li>Measurements of the patient’s injury ROM that can be immediately and independently verified . </li></ul></ul><ul><ul><li>“ Cervical Flexion is 60 ˚ today” </li></ul></ul><ul><ul><li>“ Left Foot Dorsi Flexion is 12˚” </li></ul></ul><ul><li>Subjective Opinion </li></ul><ul><ul><li>Non-quantitative information that is not verifiable at any time. </li></ul></ul><ul><ul><li>“ Pt states his neck still hurts.” </li></ul></ul><ul><ul><li>“ ROM is much worse today.” </li></ul></ul>
  24. 24. <ul><li>Injury Deficit </li></ul><ul><li>Defined </li></ul>
  25. 25. Injury deficit - illustrated <ul><li>The difference between the initial injured ROM </li></ul>
  26. 26. Injury deficit - illustrated <ul><li>The difference between the initial injured ROM and the recovered ROM </li></ul>
  27. 27. Injury deficit - illustrated <ul><li>The difference between the initial injured ROM and the recovered ROM is the injury deficit . </li></ul>
  28. 28. Injury deficit - illustrated <ul><li>The difference between the initial injured ROM </li></ul><ul><li>and the recovered ROM </li></ul><ul><li>is the injury deficit . </li></ul>and an objective based case value metric
  29. 29. Your Competitive Edge with OPM? <ul><li>This valuable Information is available only to our client </li></ul><ul><li>The OPM Screen™ is a 3 rd Party Work Product Report. </li></ul>
  30. 30. Case Valuation Principles <ul><li>Use the objective based injury deficit findings as your basis for calculating your wage loss claim. </li></ul><ul><li>You will possess the only data that any jury would understand as a loss and how you calculated the amount of the loss. </li></ul><ul><li>Your claim values for injury cases will lead the firms in your area. </li></ul>
  31. 31. Value of eMetrex? <ul><li>We quantify the injury improvement or injury deficit of: </li></ul><ul><ul><li>every injured motion </li></ul></ul>
  32. 32. Value of eMetrex? <ul><li>We quantify the injury improvement or injury deficit of: </li></ul><ul><ul><li>every injured motion </li></ul></ul><ul><ul><li>by every treating provider </li></ul></ul>
  33. 33. Value of eMetrex? <ul><li>We quantify the injury improvement or injury deficit of: </li></ul><ul><ul><li>every injured motion </li></ul></ul><ul><ul><li>by every treating provider </li></ul></ul><ul><ul><li>for every documented treatment visit from the first documented ROM finding through out the treatment history. </li></ul></ul>
  34. 34. What injuries can we document? <ul><li>All joints from the </li></ul><ul><li>Jaw to the Toes </li></ul><ul><li>Documented in the claim file </li></ul>
  35. 35. <ul><li>Our Services </li></ul>
  36. 36. Our Services? <ul><li>We identify all objective data in the file </li></ul>
  37. 37. Our Services? <ul><li>We identify all objective data in the file </li></ul><ul><li>We process the data with our proprietary technology </li></ul>
  38. 38. Our Services? <ul><li>We identify all objective data in the file </li></ul><ul><li>We process the data with our proprietary technology </li></ul><ul><li>We produce a non-biased summary of every injury motion for every visit by every treatment provider </li></ul>Narrative Summary Graphic Summary
  39. 39. Some benefits of the narrative summary <ul><li>Case Demographics </li></ul>
  40. 40. Some benefits of the narrative summary <ul><li>Case Demographics </li></ul><ul><li>Summary of Medical Reviewer </li></ul>
  41. 41. Some benefits of the narrative summary <ul><li>Case Demographics </li></ul><ul><li>Summary of Medical Reviewer </li></ul><ul><li>Summary of Initial and Current Deficits </li></ul>
  42. 42. Some benefits of the narrative summary <ul><li>Case Demographics </li></ul><ul><li>Summary of Medical Reviewer </li></ul><ul><li>Summary of Initial and Current Deficits </li></ul><ul><li>Unusual findings </li></ul>
  43. 43. Some benefits of the graphic summary <ul><li>A picture is worth a thousand words </li></ul>
  44. 44. Some benefits of the graphic summary <ul><li>A picture is worth a thousand words </li></ul><ul><li>Identify the Point of Maximum Medical Improvement (MMI) </li></ul>
  45. 45. Some benefits of the graphic summary <ul><li>A picture is worth a thousand words </li></ul><ul><li>Identify the Point of Maximum Medical Improvement (MMI) </li></ul><ul><li>Identify Special Evaluations </li></ul>
  46. 46. Some benefits of the graphic summary <ul><li>A picture is worth a thousand words </li></ul><ul><li>Identify the Point of Maximum Medical Improvement (MMI) </li></ul><ul><li>Identify Special Evaluations </li></ul><ul><li>Identify case age of treatment </li></ul>
  47. 47. Some benefits of the graphic summary <ul><li>A picture is worth a thousand words </li></ul><ul><li>Identify the Point of Maximum Medical Improvement (MMI) </li></ul><ul><li>Identify Special Evaluations </li></ul><ul><li>Identify case age of treatment </li></ul><ul><li>Identify current deficits </li></ul>
  48. 48. Litigation benefit of the graphic summary <ul><li>Jury Friendly – EZ to Read </li></ul>
  49. 49. Litigation benefit of the graphic summary <ul><li>Jury Friendly – EZ to Read </li></ul><ul><ul><li>Easy to see treatment trends </li></ul></ul>
  50. 50. Litigation benefit of the graphic summary <ul><li>Jury Friendly – EZ to Read </li></ul><ul><ul><li>Easy to see treatment trends </li></ul></ul><ul><ul><li>Easy to understand injury motion </li></ul></ul>
  51. 51. Litigation benefit of the graphic summary <ul><li>Jury Friendly – EZ to Read </li></ul><ul><ul><li>Easy to see treatment trends </li></ul></ul><ul><ul><li>Easy to understand injury motion </li></ul></ul><ul><ul><li>Easy to follow injury recover or deficit time-line </li></ul></ul>
  52. 52. Litigation benefit of the graphic summary <ul><li>Jury Friendly – EZ to Read </li></ul><ul><ul><li>Easy to see treatment trends </li></ul></ul><ul><ul><li>Easy to understand injury motion </li></ul></ul><ul><ul><li>Easy to follow injury recover or deficit time-line </li></ul></ul><ul><ul><li>Easy to follow explanation of injury deficits </li></ul></ul>
  53. 53. Litigation benefit of the graphic summary <ul><li>Jury Friendly – EZ to Read </li></ul><ul><ul><li>Easy to see treatment trends </li></ul></ul><ul><ul><li>Easy to understand injury motion </li></ul></ul><ul><ul><li>Easy to follow injury recover or deficit time-line </li></ul></ul><ul><ul><li>Easy to follow explanation of injury deficits </li></ul></ul><ul><li>Attorney Friendly – Easy to tell your story to the jury </li></ul>
  54. 54. The Winner? <ul><li>One side will own the best objective based medical information of the entire treatment history and not just a snapshot in time. </li></ul>
  55. 55. The Winner? <ul><li>One side will own the best objective based medical information of the entire treatment history and not just a snapshot in time. </li></ul><ul><li>One side will know when to cut their losses and settle quickly. </li></ul>
  56. 56. The Winner? <ul><li>One side will own the best objective based medical information of the entire treatment history and not just a snapshot in time. </li></ul><ul><li>One side will know when to cut their losses and settle quickly. </li></ul><ul><li>One side will know when to litigate without rolling the dice. </li></ul>
  57. 57. The Winner? <ul><li>One side will own the best objective based medical information of the entire treatment history and not just a snapshot in time. </li></ul><ul><li>One side will know when to cut their losses and settle quickly. </li></ul><ul><li>One side will know when to litigate without rolling the dice. </li></ul><ul><li>On side will have a tool that any jury would understand </li></ul>Treatment Trends
  58. 58. The Winner? <ul><li>One side will own the best objective based medical information of the entire treatment history and not just a snapshot in time. </li></ul><ul><li>One side will know when to cut their losses and settle quickly. </li></ul><ul><li>One side will know when to litigate without rolling the dice. </li></ul><ul><li>On side will have a tool that any jury would understand </li></ul><ul><li>One side will become the 1 st called firm there area for soft-tissue injuries. </li></ul>Treatment Trends
  59. 59. <ul><li>Win with </li></ul><ul><li>Objective Performance Metrics </li></ul><ul><li>(OPM) </li></ul>
  60. 60. What’s Hiding in Your Files? <ul><li>Let us help you to be the first called in your area for soft-tissue injuries. </li></ul><ul><li>Let us help you negotiate from a position of knowledge. </li></ul><ul><li>Let us help you monitor your case inventory. </li></ul>
  61. 61. Your POC <ul><li>Roy Koenig, BSN, RN, LC </li></ul><ul><li>Honolulu, HI </li></ul><ul><li>808-478-3557 (cell) </li></ul><ul><li>[email_address] </li></ul><ul><li>www.ClaimProfile.com </li></ul><ul><li>Files can be sent to us electronically or USPS </li></ul>

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