The Physician Network provides independent medical reviews of disability claims to determine work capacity. Their physicians are trained to objectively evaluate function based on medical evidence rather than advocate for patients. Through attending physician interviews and peer-to-peer discussions, their reviewers are effective at obtaining agreement on medically supported restrictions and limitations. Data shows the Physician Network successfully consults with treating physicians in 86% of cases, with the physician agreeing with the reviewer's findings in 67% of cases without dispute. Their written reports are also completed faster than industry benchmarks.

1. The Physician
Network, Inc.
®
Short & Long Term Disability
Disability insurance was designed to provide income for those
with an injury, illness or condition that results in a loss of function,
preventing the employee from earning a living.
Disability or Work Capability?
Today’s challenges:
Too often physicians inaccurately label their patients “disabled”
for several reasons: they lack training in understanding how to
objectively assess function; they believe they are helping their
patients by being their advocate; or they rely on uncorroborated
data. Some physicians believe that a patient is “entitled” to
“total disability” simply based upon the fact that the patient had
or claims to have had an injury or illness, without consideration
for what impact, if any, the injury or illness actually has on the
patient’s ability to function. Others, in an effort to “err on the side
of caution” propose restrictions and limitations (R&L’s) as a precautionary measure as opposed to providing medically supported R&L’s. Many physicians are also reluctant to return patients
to work out of fear of re-injury and malpractice lawsuits.
The value of a well-trained, independent
medical consultant:
A physician experienced in treating patients with injuries and
illnesses that is also trained to objectively evaluate function is
neither a “patient advocate” nor an “insurance doctor”. This
physician assumes nothing; everything is decided based solely
upon the facts: medically supported diagnoses, recorded patient
interviews, video surveillance, diagnostic studies and personal
experience diagnosing, treating and safely returning patients to
work who have had the diagnosis in question.
Attending Physician Interview:
The importance of a Peer to Peer discussion cannot be overstated. This is not a confrontation between two doctors, but rather a
brief, well thought out and focused discussion of the supported
facts and medically supported restrictions and limitations (R&L’s).
Based upon this approach, most patients are not “totally disabled”. Although many people have diagnoses requiring R&L’s,
most can still perform full-time work within these R&L’s. In fact,
many people can perform the essential duties of their usual jobs,
some with slight modifications, on a full-time basis. Our physicians are trained in interviewing attending physicians and are
effective at obtaining agreement on medically supported R&L’s.
Why TPN?
TPN has been in the business of medical consultation
since 1991 and has run an outsourced medical advisory program in the Disability market since 1998. TPN
has a recruitment and training process that attracts
highly skilled, independent physicians.
The TPN Result
Industry
Benchmark
10-20%
86%
15%
Successfully consulted
with the treating
physician
TPN
Outcomes
67%*
Treating physician in
aggreement with
reviewers’ findings
Reviewer concludes
patient has full-time
work capacity
97%**
No Data Available
Written report
turn-around time
20 days
7 days
*Does not include 20% of the physicians who did not dispute our assessment findings.
** Industry does not publish this data.
TPN results are based upon our best practices case selection.
What We Offer
Case Discussion with client
Comprehensive Review and Peer to Peer
Case Discussion with Detailed Medical Report
The Physician
Network, Inc.
®
164 NH Rte. 25 • Suite 2 • Meredith, NH 03253
Toll-free: 800-777-6160 / Fax: 800-999-6160
E-mail: scheduling@TPNexpert.com
www.TPNexpert.com
Providing insight into medical claims ®