QME Process for workers compensation

Asked about 2 months ago - San Francisco, CA

Are the P QME paid a based rate even if you have buckets and buckets of medical reports?

Attorney answers (5)

  1. Brett A. Borah

    Contributor Level 20

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    Answered . A PQME can charge for review of the medical records.

  2. Steven Joseph Alves

    Contributor Level 11

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    Best Answer
    chosen by asker

    Answered . PQMEs charge based on the amount of time it takes for them to review records in addition to their other services.

  3. Scott Douglas Silberman

    Pro

    Contributor Level 12

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    Answered . Depending on the amount of time the doctor spends with you and on the records, there are different codes the doctor will bill under. When there an examination is considered complex, they bill strictly by time. If you are curious on the amounts, you can see this code: https://www.dir.ca.gov/t8/9795.html

    Disclaimers: Making a false or fraudulent workers compensation claim is a felony subject to up to 5 years in... more
  4. Timothy John Egan

    Contributor Level 7

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    Answered . The doctor is generally paid based upon the amount of time put into the evaluation. An extensive medical record review costs more, but may be critical to a thorough report that covers all the issues needed to be addressed in your case.

  5. John M Connell

    Pro

    Contributor Level 18

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    Answered . In my state the IME drs do not receive a lot of money for the exam and review of records so if they have a chance to charge extra for review of a thick packet of medical records they frequently do so. Mr Borah would know if that occurs in your state, however don't be surprised if that is what happens given your description of the amount of records in your case.

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