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Independent review cases (email): is this legit? and what does it entail?

Home Personal Finance and Budgeting Independent review cases (email): is this legit? and what does it entail?

  • Avatar mero1984 
    Participant
    Status: Physician
    Posts: 26
    Joined: 06/03/2019

    This is an email i received (smells like phishing but just to be sure its not, I thought I’d ask you here). If you have any information about this sort of gigs let me know if it’s legit, and what it entails! Moreover, what kind of compensation would it provide, and does this qualify for self-employment to create one’s own 401(k)?

     

    Dear Dr. XXX,

    I hope you are doing well, I would like to know if you are interested in reviewing cases for our company. Following please find an introduction to Dane Street, a URAC accredited leader in Utilization Review, Record Review, and IME services. Dane Street works with over 170  leading Workers Compensation, Disability, Group Health and Auto Liability Carriers, Third Party Administrators, Managed Care Organizations, Employers, Pharmacy Benefit Managers and Medicare Set-Aside providers to provide customized peer review programs which assist their RN’s and adjustors in reaching appropriate medical determinations as part of the claims management process. We handle over 17,000 referrals per month with the help of a dedicated panel of over 10,000 physician advisors across the country.  We offer a comprehensive prep process to make the reviews as efficient as possible for our advisors.

    There are two types of peer reviews we offer our clients, in addition to our IME division:

    1- Utilization reviews (WORK COMP AND GROUP HEALTH PRE AUTHORIZATIONS) are Prospective or Concurrent reviews which address the medical necessity of care. The turnaround time is typically 1 to 2 days. There are 30 pages of records on average. Please note: We will provide the clinical summary, applicable Work Comp guideline, and a chronological record listing. The reviewer’s responsibility would be to answer the question(s) pertaining to the case and provide their rationale. There are 2 calls required to the treating provider on the Work Comp reviews. The first call is made by Dane Street in order to try and obtain the provider’s availability and provide your callback information. You are required to make a 2nd call to determine if the provider has any additional information to assist with your review. You should not give the provider your determination. Instead, point them to the insurance carrier for the final determination.

    2-Record Reviews (WORK COMP, AUTO, OR DISABILITY) are Retrospective reviews which may address causality, treatment, MMI, impairment, and other questions related to the case. Typically, there is a 3 to 7 day turnaround time unless otherwise specified (100 pages records on average). We will provide the clinical summary, applicable Work Comp guideline, and a chronological record listing. The reviewer’s responsibility would be to answer the question(s) pertaining to the case and provide their rationale. There may also be 1 call required with the treating provider. THESE CASES ARE REIMBURSED AT AN HOURLY RATE.

    Our nurses will prep the cases for the reviewer to include:

    -sorting and listing medical records in chronological order, removing any duplicative or irrelevant pages such as fax cover sheets

    -providing a clinical summary of the records

    -citing appropriate guidelines for each case, if applicable.

    Please feel free to contact me on my cell#XXXX with any questions. I look forward to hearing back from you.

    Best Regards

    XXX

    #224745 Reply
    Dreamgiver Dreamgiver 
    Participant
    Status: Physician
    Posts: 859
    Joined: 03/09/2017

    What is the hourly rate and who keeps track of the hours?

    #224747 Reply
    Avatar mero1984 
    Participant
    Status: Physician
    Posts: 26
    Joined: 06/03/2019

    Thats what I am asking here. I have no clue.

    #224749 Reply
    Dreamgiver Dreamgiver 
    Participant
    Status: Physician
    Posts: 859
    Joined: 03/09/2017

    Thats what I am asking here. I have no clue.

    Click to expand…

    I see. Well, this income would allow you to contribute to a solo 401k. As far as what the compensation is I’d ask the person requesting the services. As far as how much you should ask, well that’s up to you to determine what your time is worth. Anything less than $300 would not worth it for me personally, probably more for a mind numbing job such as this

    #224851 Reply
    Liked by Zaphod, mero1984

Reply To: Independent review cases (email): is this legit? and what does it entail?

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