#1 Why is my patient being sent to an Independent Medical Exam, also known as an IME?

by | For Providers, Insurance Medical Exams (IME)

QUESTION: Why is my patient being sent for an Independent Medical Exam?

ANSWER: The most common reasons your patient will be sent for an IME are: 1) there’s little visible damage to your patient’s car, 2) your patient has similar pre-existing conditions, 3) there is a delay from when the collision happened to when your patient first seeks medical treatment, and 4) there is a gap in treatment, where your patient stops treating with you and then returns to continue treatment.

Why is my patient being sent for an Insurance Medical Exam (IME)? In today’s post, we’ll share the primary reasons why and ways you may be able to help your patient avoid the IME process — or at least be prepared for it.

The first and most common reason is there’s little visible damage to your patient’s car. This comes from the misguided belief that if someone is involved in a minor-looking collision, that must mean no one was injured. As we know, that’s not true, just like when people who are involved in an accident where there is substantial damage to the car and walk away unhurt.

The second common reason is that your patient has similar pre-existing conditions. The closer in time those pre-existing conditions occurred to when the collision happened, the greater the likelihood that your patient will be sent for an IME. That’s why it’s important to make sure that you carefully document their condition when you first see them, compared to before the collision, and if they’ve had any prior similar issues or problems.

The third common reason is that there is a delay from when the collision happened to when your patient first seeks medical treatment. And probably the fourth common reason is that there is a gap in treatment, where for example, your patient was treating with you for six months, then they stopped treating for a month or two, and then they returned for treatment.

These are the most common reasons to be aware of why the insurance company may send your patient to an Independent Medical Exam or what we call Insurance Medical Exams.

As we know, 95% of the time, an IME report states that your patient doesn’t need additional treatment or that it’s not related to the car accident. For the most favorable outcome when having an IME, it’s important that your patient is well prepared.

We’re happy to assist in your patients’ preparation — even if they’re not our client. We also have a section on our website, which can be accessed anytime by your patient, that provides step-by-step information and how to get prepared for the IME process.

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