Chart reviews

[thecentral09]

Hey friends,

I am looking into getting started doing chart reviews. I am reaching out to a number of companies that another colleague has work with. Does anyone have any prior experience and chart reviews, how much does it pay? How much access to chart review is there? How many can reasonably be done in an hour?

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[painfree23]

What do u mean “chart review”

 

[nvrsumr]

Often times you get paid by the inches of chart to review. There are some old threads on this. I did some work 10 years ago and honestly can’t remember what I charged.

 

[NJPAIN]

If you’re talking “peer review” much of it pays very poorly. They will designate a file at 30 minutes time, perhaps $50. There will be records, ins company policy, etc to review and then you need to write a summary and provide references. Obviously not 30 min of work. When they shop it around and no one takes it they will then try it at 60 min. I guess once you’ve invested some time and accumulated some “canned” references and comments you can speed things up. I just couldn’t get past the initial getting paid for 30 min for something that took 120 min.

If you’re taking about other types of reviews (disability, etc) that seems to be more profitable.

 

[painfree23]

If you’re talking “peer review” much of it pays very poorly. They will designate a file at 30 minutes time, perhaps $50. There will be records, ins company policy, etc to review and then you need to write a summary and provide references. Obviously not 30 min of work. When they shop it around and no one takes it they will then try it at 60 min. I guess once you’ve invested some time and accumulated some “canned” references and comments you can speed things up. I just couldn’t get past the initial getting paid for 30 min for something that took 120 min.

If you’re taking about other types of reviews (disability, etc) that seems to be more profitable.

What is this “peer review” for?

 

[NJPAIN]

What is this “peer review” for?

Health plan denials, ongoing treatment for patients involved in MVA, etc.

 

[RoloTomassi]

What is this “peer review” for?

The devil's work

 

[painfree23]

Health plan denials, ongoing treatment for patients involved in MVA, etc.

This sounds miserable

 

[gdub25]

Yeah, please just get busier in your practice and don’t do this “chart review” crap. Anytime I have to talk with some jerk who is working for an insurance company regarding medical care I think to myself “can’t this guy do something better with their time?”. I did get frustrated one time when talking with this lady a few weeks ago and asked her if she felt fulfilled having gone to medical school and now denying care because of United healthcare’s BS medical policy. She screamed at me that I needed to practice evidence based medicine. I told her I’ll do the injection for free and take care of the patient. She hung up on me. In her defense, United’s policy did say the patient needed to complete 6 weeks of RECENT PT. The issue was that the patient did, 6 months ago with no benefit, but shortly thereafter had a MI and was lost to follow up. She came back in with clean bill of health as far as the heart was concerned and wanted the injection we had talked about. What kind of doctor would make that patient go back to PT for the same ongoing issue!? Please don’t go be that doctor.

 

[hyperalgesia]

Just to add to what @NJPAIN said, if you start doing a lot of them, you can use software that inserts canned references favored by insurance companies that suggest that exactly 8 sessions of PT and no more provide the maximal benefit to pts, etc.

The insurance companies and their proxies could obviously do this work themselves but they need to be able to put the name of a doc on the denial to make it more authoritative. At the same time they don't want to employ the doc in case they need to disavow him/her in a hurry.

That's all they want you for and they will take ANYONE who has the MD/DO. Because their standards are rock bottom, the pay is also laughable.

 

[RoloTomassi]

Yeah, please just get busier in your practice and don’t do this “chart review” crap. Anytime I have to talk with some jerk who is working for an insurance company regarding medical care I think to myself “can’t this guy do something better with their time?”. I did get frustrated one time when talking with this lady a few weeks ago and asked her if she felt fulfilled having gone to medical school and now denying care because of United healthcare’s BS medical policy. She screamed at me that I needed to practice evidence based medicine. I told her I’ll do the injection for free and take care of the patient. She hung up on me. In her defense, United’s policy did say the patient needed to complete 6 weeks of RECENT PT. The issue was that the patient did, 6 months ago with no benefit, but shortly thereafter had a MI and was lost to follow up. She came back in with clean bill of health as far as the heart was concerned and wanted the injection we had talked about. What kind of doctor would make that patient go back to PT for the same ongoing issue!? Please don’t go be that doctor.

They're straight up unethical, making medical decisions that violate the principles of beneficence, nonmaleficence, and autonomy all at once without ever seeing the patient.

There's this one that I love though. She always tells me exactly what to change to get an approval. I swear she's a double agent who infiltrated the system and is seeing how many approvals she can get before they can her.

 

[thecentral09]

So I will be working outside of a non compete for a year, and backfilling my schedule with peer/chart reviews. But I see myself being like the one that states what is needed to get approved, I’m only going to be doing it a few days/month so by the time they catch on to can me I will have don’t my time

 

[hyperalgesia]

So I will be working outside of a non compete for a year, and backfilling my schedule with peer/chart reviews. But I see myself being like the one that states what is needed to get approved, I’m only going to be doing it a few days/month so by the time they catch on to can me I will have don’t my time

The company I worked for figured it out after 2 reviews. Then they started sending the reviews back because they weren't what they wanted. That's when I called it quits.

You should try it and see for yourself.

Another thing people do is contract with the VA to do disability ratings. It's much more lucrative and reliable than chart reviews.

 

[Sparklesandstars]

Can you get into this work before finishing residency but after receiving your unrestricted medical license?