by DrDoc on Wed Aug 07, 2019 2:16 pm
I agree. Those are important factors and require adjustment. But, at the end of the day, simply looking at what is proposed, the numbers simply do not add up. The hours required for a proper psychiatric evaluation, when compared to the proposed flat fees, would simply make it economically unfeasible to stay afloat. Overhead would eat up perhaps 50% under these proposed flat fees. The current system is terrible, but one can earn a reasonable fee, after performing figurative somersaults and backflips.
The proposed rate would be far less than what an average entry-level clinical psychiatric position in a large metropolitan area in California would pay. The proposed payment scheme for review of medical records is so blatantly ridiculous, that I find it hard to comment on it in black-and-white. If the medical records consisted of six deposition transcripts alone, one would not hit the 400 page mark. If the records consisted of Kaiser boilerplate nonsense, numerous PR-2 reports (saying the same thing over and over), and padded nonsense reports from questionable evaluators, it would not be surprising for the page count to be in the thousands.
And then there is the recent proposal of removing any avenue for QME/AME to receive due process, have their day in court, if the insurance carrier simply decides not to pay for the work until the case has closed. It’s a sad day when the term “Kafkarsque” is not hyperbole.