From Insight to Action: The Smart Path Forward in IMEs

Operating With an Increased IME IQ  

At the beginning of this series, we discussed our desire to increase knowledge and understanding of the IME process. Claims adjusters and payers must be aware of the key components of an IME and the criteria that lead to a quality IME result. Adhering to best practices must be established as a priority. Otherwise, complex claims are at greater risk of becoming prolonged, complicated, and costly, and injured employees would be in jeopardy of not receiving the care they need to recover and return to work (if applicable).  

The IME process and concepts outlined in this blog series have hopefully enabled payer organizations and their claims staff to implement best practices with a deeper understanding of today’s IME intricacies. If your organization is looking to initiate improvements, it’s smart to start at the beginning by refining the processes for requesting IMEs.

Are requests being made at the optimal time? Are the requestors clearly outlining the objective of the IME? And are they providing all the necessary background information to the IME physician? The “IME Referral Tip Sheet” is a quick resource to help refine and optimize your referral decision-making.  

You must also ensure that the IME company you partner with has processes in place that deliver not only objectivity but also superior service and credible IMEs that withstand scrutiny by state commissions, WC boards, and court systems. These partners should use digital strategies to streamline the overall IME process and enable program oversight. Quality partners are the conduit for matching injured workers with the best, most qualified IME physicians, resulting in IMEs that drive informed decisions and move claims toward closure.  URAC accredited vendors will strengthen your position.

In the final blog post of the Case Resolution series, “Red Flags, Rulings & Reality" we will wrap things up addressing 3 IME Concepts That Make a Difference.  

 If you are ready to explore further, download the entire IME eBook here: Emperion eBook.  

If now is the time to request an exam, visit our online referral form.