Jim: Hi, my name is Attorney Jim Mangraviti. I’m here with Attorney Steve Babitsky from SEAK, and we’re going to talk briefly today about how physicians can perform disability reviews for insurance companies. Steve, what is the role of the physician regarding reviewing disability claims?
Steve: Physicians are asked to review claims by insurance companies and IROs. And what they generally do is they receive files electronically from these companies and they’re asked to answer specific questions based on the contract provided by the company as to whether the person is disabled, impaired, whether they can do their last job, whether they can do any job, or any different work.
Jim: And what are insurance companies looking for in doctors that perform these reviews?
Steve: Well, they’re looking for several things. The first thing, as always, is availability and accessibility. They want doctors who are available to do these reviews, who are accessible. They also are looking for doctors that can do this work in a timely fashion because a lot of this work is time-sensitive. It has to be done within 24 hours, 48 hours, 72 hours. They want high-quality work. They want physicians who are good clinicians and it’s crucially important they’re able to write an excellent report because, generally speaking, there’s no testimony, so the report is crucial to their success. So, if they’re available, they’re accessible, they can turn the workaround on time, and they can write a great report, that’s what they’re looking for.
Jim: And what are some of the advantages to a doctor to doing disability reviews for insurance companies?
Steve: Well, there are four main advantages. We could look at a slide if you’d like. First and foremost, the work can be done from home, nights and weekends. This is done 95% electronically. The insurance companies, the IROs will send you files electronically. You can do the work anytime you want. You could do it during the day, at night, weekends, or whatever. And you could do it on your home office.
The stakes are pretty high in these cases. On disability reviews, we’re looking at professionals that are filing for disability. So, these may be doctors, lawyers, dentists, accountants, and so forth. These people, if they qualify for disability benefits, could get up to $150,000 or $200,000 a year tax-free. So, the stakes are high, and therefore, the insurance companies and the clients are willing to invest in excellent work and excellent reports.
This also can lead to full-time employment. Sometimes you start out as a part-timer working for an insurance company or an IRO, they love your work. We’ve seen many examples of them after a person does some of this work for them part-time, they try to bring them on in-house and hire them full-time.
And, of course, the last advantage is this is not an adversary proceeding as medical-legal work or other expert witness work would be. As you do not examine anybody, there’s no physician-patient relationship, and therefore, you very rarely, if ever, have to testify in court.
Jim: And how much money can a doctor make doing these reviews?
Steve: Doctors can make an excellent income. They can be paid by the hour, $250 or up to $300 an hour. They can do a lot of work in a short amount of time. So, we have had doctors who’ve taken our disability file review course that tell us after taking the course, that they’re making $150,000 or $200,000 a year.
Jim: Steve, what resources do SEAK offer for doctors who want to supplement their income by doing disability reviews for insurance companies and IROs?
Steve: We have three main things, Jim. The first is we have a course called How to Start, Build, and Run a Successful Disability File Review Practice. And that’s a two-day course. We run that once a year. And that has proven to be very, very helpful for doctors. The doctors who attend that course get up and running, and within weeks after attending the course, they can have an active practice going. The second resource is a national directory, the National Directory of Medical File Review Consultants, www.filereviewconsultants.com. What happens is physicians put their name in the directory, they pay a fee for the year, and this directory is sent out across the country to all the companies that ask for file reviews. It’s also on the web. And the third thing we do, sometimes physicians don’t want to wait for the course. They get in the directory and have to get up to speed right away and they ask for help. And what we do is we work with them one-on-one to help them get up and running in their file review practice. So, we give them a handbook. We actually give them a handbook from the course. We then have a series of questions and exercises that we perform with them. We give them a list of companies that are available and looking for physicians. And again, within a month or two, they’re up and running and can have a very successful practice.
Jim: Thank you
Excerpted from SEAK’s stream on-demand course, How to Start, Build, and Run a Successful Disability and File Review Practice