MEDICAL COST PROJECTION REPORTS

At Medivest, we understand how vital documentary evidence is to help your client get a fair and sufficient settlement for their injuries. Our thorough medical cost projection (MCP) reports are a valuable resource for reaching that goal. These in-depth assessments predict the future medical costs of caring for an injured person.

Medivest’s comprehensive MCP report services help attorneys strengthen their cases by including details from an evidence-based perspective. Use them to help set reserves, negotiate settlements or audit existing cases.

In practice, the MCP report serves as a guide to estimate the cost of medical care for those injured through no fault of their own. For example, MCP reports are common in personal injury and Workers’ Compensation cases to reach a settlement that provides adequate funds for future care.

Often, the amount in the report — the “reserves” — goes into a special account administered by professionals like Medivest to ensure funds are available for care. These evaluations can also help inform a Medicare Set-Aside Allocation (MSA) amount for those who require such earmarked funds before Medicare will cover their injury-related expenses.

We specialize in MCP report preparation for common accident-related conditions, including the following:

• Brain and spinal cord injuries
• Back, neck and knee injuries
• Trauma
• Amputations
• Neurological injuries, including chronic neuropathy and complex regional pain syndrome

Our expert team of medical cost projection specialists conducts an in-depth review of medical records to identify the appropriate scope, degree, duration and fees associated with future injury-related medical treatment. We base our projection on medical information like:

• Treatment patterns appearing in the medical records
• Prescription medication usage
• Physician recommendations regarding future treatment
• Evidence-based guidelines

We also consider other relevant care needs, such as those for:

• Home healthcare
• Medical equipment like wheelchairs or prosthetics, including future replacements
• Surgical revisions or potential additional surgery

Once our team of nurses has reviewed the records, our certified coders step in. They examine the allocations and projections for accuracy based on the most current guidelines and “usual, reasonable and customary” (URC) fee schedules in your client’s geographic area.

Many circumstances support the use of a MCP report, including:

• Demonstrating the extent of an injured person’s future anticipated care expenses before negotiations.
• Setting reserves for settlement planning or verifying existing reserves are correct.
• Meeting tight budget needs on smaller cases.
• Preparing for mediation or litigation.
• Meeting shorter case time frames.
• Handling a Workers’ Compensation claim that’s not likely to settle and keeping an open medical claim administered by a professional.

Because each injured person’s case is unique, individualized assessments are crucial. The highly trained team at Medivest reviews various information to compile a personalized report, including:

• Physician reports
• Medical records
• Expert opinions

We may also rely on interviews and phone calls if necessary to clarify a point or get additional details. Cooperation from your client’s care team is always valuable in helping us create the most accurate report.