Independent Medical Evaluations
We have extensive experience in providing independent, objective, and accurate evaluations of claimants’ status of disability, functionality, diagnosis, prognosis, impairment, causality, treatment, reasonableness of care, medical necessity, maximum medical improvement, pre-injury status, and employability.
Functional & Physical Capacity Evaluations
Our experts’ functional and physical capacity evaluations utilize best practice testing protocols, administering an objective and extensive battery of performance tests that assess a comprehensive list of factors to determine an individual’s ability for work, ability to perform specific job tasks, and physical restrictions for work and daily activities. Crosspoint Evaluations’ services are utilized by government agencies, employers, insurance companies, attorneys, and vocational experts to determine levels of functional and physical ability for an individual to safely return to work and perform essential job functions.
Medical Record Reviews
Crosspoint Evaluations’ medical record review services are designed to respond to our clients’ needs for reviewing medical decisions made by insurance companies or employers regarding claims determinations. Crosspoint Evaluations’ staff reviews each case and selects experts from our panel to determine the required services necessary to assess work capacity, causality, medical treatment necessity, cosmetic treatment, surgery and facility or out-patient length of stay, reasonableness of care, preventive care options, and patient care management. Our record review processes involving communications with governmental agencies, large health and casualty insurers, and benefits administrators meet rigorous federal, state, and local regulatory requirements to ensure the integrity and credibility of our reports.
Peer Reviews
Crosspoint Evaluations provides evidence-based peer reviews by an experienced panel of American Board of Medical Specialty-certified experts from all medical specialties. In order to determine compliance with accepted health care standards, our expert panelists evaluate the work performed by their colleagues in examining and assessing the medical and non medical documentation and reports provided. Our expert opinions address factors of causality, impairment, functionality, restrictions and limitations, severity of diagnosis, necessity of medical services and care, reasonableness and appropriateness of medical treatment, mitigating conditions, treatment recommendations.
Medical & Physician Bill Review
Crosspoint Evaluations offers comprehensive bill review services for all in-network and out-of-network bills, including PPO management, medical bill re-pricing, line-item review, professional nurse review, and automated adjudication. Our team of physicians, nurses, and coding experts utilize multiple electronic data exchanges and automated web-based applications to ensure accurate and consistent bill reviews to identify excessive, inappropriate, inaccurate, and duplicate charges ultimately resulting in increased claims management and bill review accuracy and consistency and often substantial cost savings to our clients.
Workers’ Compensations Services
Our panel of experts include Qualified Medical Evaluators experienced in providing QME’s and AME’s. We provide timely evaluations for early intervention, medical request certification, bill review, medical treatment plans and return-to-work programs which advocate care for injured employees and result in improvements in clients’ claims and risk management programs.