How RateFast Benefits Your Medical Practice

When most medical professionals think of workers’ compensation, the terms “painless,” “fast,” and “easy” do not leap to mind.

However, we believe that the problems associated with workers’ compensation cases can be solved.

RateFast is a cloud-based application that makes workers’ compensation fast, easy, and lucrative for California providers.

While physicians and staff focus on patients, RateFast handles the dirty-work.

Here are just a few ways that RateFast saves your medical practice time:

  • When you use RateFast, you don’t need to do any dictation or take any notes. All data is quickly entered into RateFast.
  • You don’t even need to write the report. As you check boxes and answer simple questions, your Doctor’s First, PR-2, and PR-4 reports are automatically filled out and formatted.
  • You don’t need to fill out RFAs. The app automatically generates and organizes Requests for Authorization forms as you order treatments.
  • You don’t need to write work status notes. Faxable work status notes are automatically generated as you answer questions about the patient.
  • You don’t need to calculate an impairment rating. The system prompts you to ask all questions that are relevant to the patient’s whole person impairment. Then, the system calculates an accurate and fully justifiable impairment rating using proprietary algorithms that are rooted in the AMA Guides 5th Edition.

The bottom line: if you’re a California medical provider or work in a California medical clinic, we believe you can benefit from RateFast.

No installations. No downloads. No obligation. No risk. Free training and support.

Sound too good to be true? Try it for yourself. Join for free.

All you need is an email address and a desire to improve the California workers’ compensation system.

If you join before the end of January 2017, you will even receive a 50% discount on all reports for the next six months!

To learn more from a sales representative, contact us at

The Art of the Qualified Medical Exam

A QME is a medical professional who is credentialed by the state to perform qualified medical examinations required for certain workers’ compensation cases. For a more detailed look at what a QME is, take a look at this article.

Recently on the RateFast Work Comp Report podcast we interviewed Dr. Nissen about being a Qualified Medical Examiner (QME). Dr. Nissen discussed what he called “the art of the QME”—a skillset that involves using creativity and critical thinking to overcome several unique challenges.

A few of these challenges are described below.

Understanding the American Medical Association Guide to Impairment Rating and Evaluation.

Using the huge tome commonly known as the AMA Guides demands a depth-of-knowledge that few physicians take the time to develop. In order to serve as an effective impartial examiner, the QME is responsible for knowing the Guides back-to-front. This knowledge directly informs all other aspects of QME’s work with the claim, from performing the physical exam to determining impairment.

Assessing previous medical charts.

Medical charts for a single patient are often hundreds of pages long, and the ability to review them for relevant information takes practice, insight, and real-time analysis.

Performing an accurate physical evaluation.

The QME evaluates the patient according to the Guides, reviewing all thirty-four activities of daily living, and taking repeated measurements depending on the type of injury. A correct evaluation requires extensive knowledge of the Guides and rigorous attention to detail.

Creating a precise and correct impairment rating.

All of the relevant medical charts and all new information generated by the QME’s physical exam must be collected into the QME’s report. This data must be accurate; after all, the QME’s role is to bring objectivity to the claim, so reproducibility of results is key.


Dr. Nissen argues that in order for QME reports to truly benefit injured workers, physicians need a system for collecting consistent data. Accurate and meaningful data results in less legation, and ultimately the speedy close of the workers’ compensation claim.

Fortunately, such a system has been developed. RateFast is a total workers’ compensation solution that helps providers perform perfect exams, document patient medical histories, format and organize reports, and determine impairment ratings according to the AMA Guides. We urge medical providers, QMEs, and anyone who is interested in improving workers’ compensation to join RateFast for free.

How Telemedicine Benefits Injured Workers

This is a post for medical providers, employers, and employees who are interested in understanding how telemedicine can improve workers’ compensation in California.

Doctor working on a digital tablet

When it comes to workers’ compensation, who benefits from telemedicine? The short answer: everybody. But the gains will be immediately apparent to the injured worker.

First, let’s think about how an injured worker currently experiences the workers’ compensation process.
Continue reading How Telemedicine Benefits Injured Workers

The Eagle Has Landed. Its name is RateFast!

California workers’  compensation care delivery technology history was made by a partnership between Alchemy Logic System Inc., dba RateFast (Santa Rosa, CA) and KuraMD (Roseville, CA).

Santa Rosa, CA, October 11, 2016 at 4:38 p.m.pst

Dr. John Alchemy, MD, QME successfully connected to an injured worker for a PR-2 visit using the HIPAA secure environment of KuraMD telemedicine platform. A complete history and physical exam was performed, followed by the creation of a legally compliant PR-2 report and an MRI request for authorization (RFA) written on using only the Apple iPhone 6+ device. The iPhone was being simultaneously charged by a 2013 Tesla Model S 85 Kwh battery. This landmark event is the first documented instance of 100% mobile delivery of care to an injured worker.

Dr. Alchemy was later quoted saying, “I just never gave up hope. RateFast has already disrupted the category of workers’ compensation report writing and injury mapping. Now with KuraMD that delivery channel is totally mobile. Effective delivery of work comp care in California has just been turned on 24/7, anywhere, anytime-and it’s in your pocket now.”

Is incomplete data affecting the accuracy of your impairment rating?

This article is for medical providers, insurance adjusters, attorneys, and injured workers who want to understand common causes of inaccurate impairment ratings.

Correct impairment ratings save time and money for all stakeholders; they result in correct apportionment for subsequent claims, and allow predictable trends and costs for data analysis and work risk assessment. Of course, the inverse is also true: inaccurate impairment ratings cause claims to consume the time and resources of everybody involved.

One of the best things you can do to check the accuracy of an impairment rating is to make sure that you’re working with a complete data set. In other words, make sure that the provider—or whoever is doing the impairment rating—has all the necessary information.

A complete data set supports an accurate rating, which decreases the risk that the rating will be contested, which means a faster, easier workers compensation claim for all parties.

So why don’t all workers’ compensation claims have complete data? Here are three common circumstances that lead to incomplete data sets:

  1. Sometimes the required information is not obvious. This is especially common in cases involving the spine with patient symptoms such as radiculopathy.
  2. The importance of some data about the injury isn’t always clear to medical providers, so they don’t ask the necessary questions or take the necessary measurements. For example, if an employee has injured her left shoulder, then the provider might not ask detailed questions about the pre-existing history of the right shoulder. However, for upper extremity injuries, the history of the uninjured side of the body can actually affect the impairment rating of the injured body part.
  3. A stakeholder might omit data in order to intentionally increase or decrease the impairment rating. This is considered fraud by the state of California, which you can read more about here.

Let’s look at an example. A twenty-year-old old delivery driver has a back injury. When she reaches maximal medical improvement, a provider examines her. She is pain free and takes no medication, has no problems with her activities of daily living, and takes no medications. It seems as though her injury has not impacted the employee at all, and so the provider concludes that there are no ratable findings. The provider skips the medical history and assigns the patient a 0% whole person impairment. Is this correct?

No. The rating assessment was incomplete. If the provider had taken the full history, then they might have discovered that the patient had L3 dermatomal sensory loss directly after the injury, with imaging showing a concordant herniated disk at that level. Although there were no ratable findings at the time of the final exam, the AMA Guides 5th edition mandates a 5% whole person impairment because she had radiculopathy, even though it is now gone (Category II, Table 15-3, Page 384).

However, only providers who are intimately familiar with the AMA Guides will check for radiculopathy.

In summary, incomplete data are more common than you think. For this reason, we recommend using a tool such as RateFast to ensure that all the relevant questions are answered. Get your free account today.


How to Update Your Credit Card in RateFast

This post is for RateFast users who want to update their credit card information on RateFast. This article assumes that you already have an account with RateFast. Last updated September 12th, 2016. 

1. Log in to your account.

Visit and click the “Log In” button. Then enter your credentials and click “Sign In”.




2. Go to your Practice Profile.

Click on your user icon at the top right hand side of the screen. Select “Practice Settings” from the drop down menu, then click on “Credit Card Information” under Practice Profile.



3. Enter in your new credit card number and expiration date.

Type in your new card number and date of expiration. Then scroll to the bottom of the screen and click “Update”.


You’re done! Don’t forget to update your credit card information before your card expires.

For more information on account types and user permissions, click here. To learn about RateFast’s privacy policy, visit this page. If you have any questions or comments email or call the help desk at 707-304-5949.

How to create PR-4 reports in RateFast

This post is for RateFast users who want to use the RateFast web application to write a PR-4 report. This article assumes that your patient and their injury have already been created in your RateFast practice account. Last updated August 30th, 2016.

Do you want to use RateFast to write a perfect PR-4 report—complete with an accurate impairment rating? You’ve come to the right article. Here’s what you need to do to write a PR-4 report for your patient and help conclude their work injury claim.

1. Confirm that the injured employee is ready for a PR-4 report.

The physician must complete a PR-4 report when at least one of the body parts has become permanent and stationary, or reached MMI (maximum medical improvement). If none of the patient’s injured body parts have reached MMI, then they aren’t ready for a PR-4 report. Instead, they might need a PR-2 report or a Doctor’s First report.



2. Login to RateFast and find your patient.

If your patient definitely needs a PR-4 report, then login to RateFast and navigate to the patient.login3

3. Select the correct injury.

Your PR-4 report is related to one particular injury or work-related incident. If your patient has had multiple work-related injuries/incidents, then select the appropriate date of injury.


4. Create a PR-4 report.

Click the “Add report” icon, and then click the “PR-4” button.createpr42

5. Update the patient’s “Background Information” if necessary.

On the “Background Information” section of your report, verify that your patient’s information is up to date.

6. Select the body parts that have reached MMI (Maximum Medical Improvement).

On the “Injured Body System(s)” section of your report, examine the “Which body parts have reached MMI section?”

The body parts associated with the work injury will be listed here. Check the checkbox next to the body parts that have reached MMI. You cannot write a PR-4 report for a body part that has not yet reached MMI. If a body part hasn’t reached MMI, then it needs a PR-2 or Doctor’s First report, rather than a PR-4 report.


7. Select the body parts that you would like to have rated.

Usually, if a body part has reached MMI, then you will want to select it for rating by clicking the “Yes” button. Only the body parts that you have selected for rating will be included in your PR-4 report. Body parts that you have not selected for rating will not appear in your PR-4 report.


If the employee’s work-related injury/condition has affected multiple body parts, then different body parts might reach MMI at different times. Therefore, not all of the body parts will be ready for rating on the same date. But you can write a PR-4 report for the body parts that are ready for rating today, and then write another PR-4 report for other body parts after their conditions improve and eventually reach MMI.

8. Review and update the other sections of the PR-4 report.

The PR-4 report can be the most important report in a workers’ compensation claim, so it’s good to include as much relevant information as possible.

Information from previous reports you have written for this injury will import into your PR-4 report. Take time to look at each section and decide if you want to include that section in your PR-4 report.

Note: some sections, such as the “Activities of Daily Living” section, and the “Objective Findings – Body Part” sub-sections will always be print in your PR-4 report.

9. Complete critical sections.

Some sections are very important, and must be completed in order to receive an accurate an impairment rating.

The “Objective Findings” sections for body parts are particularly important. For example, if the employee has injured their left shoulder, then you should complete the “Objective Findings – Upper Extremity – Shoulder – Left” section, and provide all the range of motion measurements.objfinding


10. Preview your report.

Click the “Preview” button to examine your report. Make sure that all of the information is correct, and that all the important information is displaying.preview


11. Submit your report for rating.

After you have verified that your report is complete, then click the “Submit for Rating” button. After you click “Confirm”, then your report will be sent to RateFast, and an impairment rating will be calculated based on the data you have provided.

12. View your completed report.

After 3 business days, you will receive an email alerting you that your PR-4 report is now complete with an impairment rating. Click the link in the email to login to RateFast. You can quickly navigate to your PR-4 reports by clicking the “Completed PR-4 Reports” button at the top of the screen after you login.

Click the “View” button to look at the text of your PR-4 report. Your impairment rating will be below the Whole Person Impairment (WPI) heading.

We believe that the impairment rating is one of the primary benefits of RateFast and we stand by the accuracy of the impairment rating assigned to your report. Your impairment rating is calculated using proprietary algorithms derived from the AMA Guides, and will include references to specific page numbers, chapters, and tables in the Guides. If you have a question about the basis or accuracy of a RateFast impairment rating, please contact us at

13. Download your report.

Click the “Save to Doc” button in order to save your report as a document on your computer. You can then email, file, or fax the report as you wish.


Gender Discrimination in Workers’ Compensation

A lawsuit filed in July of 2016 argues that female workers receive fewer benefits than males in the California workers’ compensation system. According to this USA Today article, the lawsuit makes a case that women are systematically prevented from receiving full benefits for two primary reasons:

  1. Some medical conditions, such as carpal tunnel syndrome, are allegedly more common among women.
  2. The consequences of some conditions, such as a mastectomy performed in order to treat breast cancer, are not seen as causing disability.

Although we don’t know the full details of the lawsuit, the news coverage about the case raise some important questions that everybody involved in workers’ compensation should understand.

In this article, we’re going to take a close look at how apportionment, functional loss, and gender can impact an injured worker’s disability rating and benefits.
Continue reading Gender Discrimination in Workers’ Compensation