Analysis of Medical Expenses
Medical expenses, past and future, are often the largest element of damages in a personal injury case. Indirectly, medical expenses are often the keystone used to calculate non-economic damage elements. Plaintiff and defense counsel know to analyze the plaintiff’s medical expenses carefully.
RPC has the data, expertise, and experience to assist counsel in personal injury cases by analyzing past and future medical expenses. Here are some of the specific ways we have assisted:
- Section 18.001 Counter Affidavits – RPC has prepared hundreds of counter-affidavits on claims from all types of practitioners and facilities. Counter affidavits on reasonableness of charges by RPC staff have been accepted by courts throughout the state. We have consulting physicians in several specialties who can provide counter-affidavits on medical necessity. A white paper posted on our website explains our sources and methods.
- Reports on Past Medical Expenses – As an alternative or in addition to counter-affidavits on specific claims, RPC staff and consulting physicians can prepare comprehensive reports on a plaintiff’s past medical expenses. These reports assist counsel in mediations. They can be updated as new treatment occurs. In addition to medical necessity and reasonableness of charges these reports address:
- Treatment due to pre-existing conditions and not the event
- Cost-effective treatment alternatives
- Coding and other billing errors on claims
- Cost of services using rates when applicable to the plaintiff for workers’ compensation, Medicare, commercial health plans and other coverages
- Life Care Plans – RPC has prepared hundreds of life care plans for plaintiff counsel and analyzes life care plans for defense counsel. We have certified life care planners. We work with physicians identified by counsel and can recommend consulting physicians and neuropsychologists. We have staff economists calculate discounted present value. This complete team saves counsel time and money. A white paper posted on our website explains how we develop costs for life care plans.
- Alternative Cost Projections for Life Care Plans – National standards require life care planners to use billed charges or retail prices in life care plans. Some plaintiffs have reasonably certain lifetime insurance coverage for treatment related to the injury. Examples are Medicare for a person over 65 or a permanently disabled person or a workers’ compensation insurance policy. RPC economists can reprice a life care plan to rates available to the plaintiff in a separate report.
- Resolution of Medical Liens – RPC has assisted plaintiffs in resolving hospital liens for less than billed charges by analyzing the hospital’s cost to provide the services, the negotiated rates the hospital has accepted as payment in full, and the usual, customary, and reasonable charge for the services. Following the North Cypress decision, RPC can help counsel draft discovery requests to the hospital and can defend the reasonableness of the discovery request.
Analysis of medical expenses is important in personal injury cases. We also have experience and expertise analyzing large numbers of medical claims data in medical fee disputes, False Claims Act cases and contractual disputes.
View RPC’s Personal Injury Litigation Services Here