RateFast Podcast: Institutional Bias and What You Can Do to Prevent It

People have the tendency to cut corners sometimes. This might come as a surprise to some, but in some cases doctors are no exception.

That said, cutting corners doesn’t necessarily mean that the job is done lazily. For a doctor this can happen because they are pressed for time, they are making an inference based off of prior experience, even outside forces could be pressuring them to fill in a number here and there.

When cutting corners like this becomes routine, we get institutional bias.

Our interview with Dr. John Alchemy covers institutional bias, why it happens, and what doctors could do to avoid dragging out their claims by letting their bias get the better of them. Listen to the podcast on iTunes here.

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RateFast Podcast: Came for surgery, left with some antidepressants?

After they ask themselves the 3 questions before referring a patient to a spine specialist, your provider may follow through, and when a primary treating physician refers an injured worker to the specialist for diagnostic tests, the worker might suspect that there is surgery ahead. This is not always the case.

In fact, there’s a chance that they might even leave the specialist’s office with a prescription for antidepressants, among other possibly unexpected treatments.

RateFast’s own Dr. John Alchemy and Claire Williams interview orthopedic surgeon Dr. Athanassious about the circumstances surrounding complications with spinal injuries in injured workers, and where the primary treating physician may direct them when more specific care is needed. Click here to listen to the podcast on iTunes.

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RateFast Podcast: Understanding the RFA

In workers’ comp, providers must fill out a Request for Authorization form (RFA) when requesting a service, treatment, or tests for a patient. The RFA must be filled out correctly in order to receive approval from the employer’s insurance.

This excerpt from our podcast on How To Submit an RFA features RateFast’s founder Dr. John Alchemy in conversation with Arun Croll and Claire Williams about the intricacies and limitations of the Request for Authorization process.

There are certain steps that providers can take to make an RFA likely to be accepted, such as making sure that appropriate ICD-10 codes are included on the form. Insurance carriers may deny an RFA for all kinds of reasons, so it’s imperative to be as thorough as possible.

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RateFast Podcast: What are The Chances? Probability and RateFast

An educated prediction is a critical element in decision-making when face to face with the future. This is because the future is always uncertain.

Whether you’re making bets, conducting a weather forecast, or working in medicine, knowing the probability that something will or will not happen can have a huge impact on which action to take next.

Making observations to measure the probability of an event happening involves collecting data from past events in order to compare them to the expected outcome. This is why we can have a sense of confidence as to when we should bring an umbrella, buy buy buy, or sell sell sell.

Check out our podcast titled Probability in Workers’ Compensation with RateFast intern Marten Thompson, where we discuss probabilities, Sherlock Holmes, and more.

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Greater Than or Equal To: Percentiles and RateFast

A percentile is a value below which a percentage of data falls.

This means that if you are in a group of 10 people, and you are the 9th tallest at 6 foot 5 inches, then 6′ 5″ is the 80th percentile height in your group. Note that the value falls below your point in the data set.

It is difficult to dispute the numbers when they are on paper, but what happens when there is a dispute about how that data is organized?
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Common Objections to Workers’ Comp Reports: Incomplete Activities of Daily Living (ADLs)

This article is part of a series on the top reasons why insurance carriers object to a workers’ compensation report and return it to the medical practice unpaid. This article is intended for medical providers, administrative staff, office managers, as well as insurance claims adjusters.

In our previous post of this series, we discussed the history of symptoms in the doctor’s impairment PR-4 report. The following section covers the next step in the subjective complaints category.

You are facing the possibility that your report could be returned, possibly for the second time, and it is very important to you and your patient that you cross your t’s and dot your i’s so that you make this as timely of a process as possible. Like anything else, taking a few moments to take extra care can save your hours or even days of trouble in the future.

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Common Objections to Workers’ Comp Reports: Incomplete History of Symptoms

This article is part of a series on the top reasons why insurance carriers object to a workers’ compensation report and return it to the medical practice unpaid. This article is intended for medical providers, administrative staff, office managers, as well as insurance claims adjusters.

You’re at the clinic and you receive a fax or a letter from an insurance carrier related to an impairment PR-4 visit with a workers’ comp patient

Payment for the visit? Not quite.

Continue reading Common Objections to Workers’ Comp Reports: Incomplete History of Symptoms

Top 5 Articles of 2016

From how to use an inclinometer correctly to understanding why a panel QME gets involved in a work injury, read up on the best workers’ compensation content of the past year.

  1. What’s A QME?
  2. Muscle Atrophy
  3.  Exacerbation vs. Aggravation
  4. Activities of Daily Living
  5. How to use an Inclinometer

Do you have a workers’ compensation topic you’d like to see covered? Email us and we’ll put our best people on it!