An IMR is an Independent Medical Review.
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An IMR a medical document review or a file review performed by an independent physician or a non-treating physician at the request of a 3rd party.
An IMR is only a Medical Document Review.
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An IMR involves a review of provided medical documents such as clinical notes from primary care providers, specialist consultations, diagnostic imaging, special investigations and treatments.
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There is no contact between the reviewing physician and the individual whose medical documentation is being reviewed.
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There is no obligation on the physician to clinically evaluate the individual whose documentation is being reviewed.
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The physician’s only obligation is to provide an opinion to the 3rd party that requested the medical document review.
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The requesting 3rd party provides factual material and medical information about the person whose documents are to be reviewed.
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The reviewing physician answers specific questions asked by the 3rd party.
The purpose of the IMR is to:
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provide an opinion on a diagnosis, investigations done, treatments received, adverse events or complications experienced by an individual.
The IMR is valuable as:
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a first step in the early stages of a medical legal case where there is uncertainty regarding the diagnosis, work-up and treatments received by a claimant.
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a cost effective way to determine the strength of a case.
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to determine if “standard of care” was met.
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to determine if it is worth proceeding with a more comprehensive file review and or clinical consultation.
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to determine the need for a full IME
Types of IMR's
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Basic IMR
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Comprehensive IMR