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Florianman kleinman

Insurance Defense at statue of liberty
Phone 8053878605 ext 2
Email flofloflo@floflo.com
Website -
Address 123 moliere avenue
thousand oaks
CA, 91360

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Med-Legal Payments Set for First Drop in a Decade, CWCI Reports

By Greg Jones (Deputy Editor)

Friday, March 2, 2018 | 1137 | 2 | 53 min read

The average cost of medical-legal services may be declining for the first time in a decade, according to a California Workers’ Compensation Institute analysis of payments made through the first six months of 2017. Stacy L. Jones (CWCI photo) CWCI’s review also found a high concentration of qualified medical-legal evaluators in the Los Angeles area, as well as a puzzling increase in providers billing for agreed medical evaluator services. Comp carriers paid on average $1,538 per medical-legal service provided between January 2017 and June 2017, the latest month CWCI reviewed fo...

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Dr. Ron Perelman Mar 2, 2018 11:16 AM

A QME list of 3 is generated. If the parties agree on one of the 3 ( no striking) a Joint QME letter is sent to the QME. It is signed by both parties, like an AME. At seminars in the past, doctors were told that this report is the same as AME, however, it is due in 30 days. The complexity involved is identical to an AME. If the DWC believes this is not the case, then QMEs need to be clearly told they cannot do this

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Scott Thompson Mar 2, 2018 11:46 AM

I believe the rule was changed in 2013, and the 94 modifier was restricted only to AMEs, not joint or "agreed" PQMEs. Prior to that, it was clear that the 94 modifier could be attached to Agreed PQMEs. I agree with you that the level of complexity is the same when you have a joint letter or separate letters from opposing counsels, so it's a mystery as to why the 94 modifier for Joint and Agreed PQMEs was ever dropped. On a separate note, and someone can correct me here, but I thought the DWC was supposed to revisit the Medical Legal Fee Schedule every 2 years and adjust for inflation. It has not been adjusted since 2007.

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