What is a Future Cost Projection, and When Does Your Client Need One?

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Medical Billing Experts

We hope it never happens to us. There is a catastrophic accident that leaves someone paralyzed, or even a workplace injury that causes the loss of digits on one or both hands. In either of these cases, accommodations have to be made for the future in order for the injured party to maintain their quality of life.

Whether it is the need to have in-home care to assist the injured person with the activities of everyday life, or the need to make arrangements for someone who has lost a thumb on their dominant hand to go through physical therapy to retrain their other hand to perform everyday tasks, there are costs associated with each.

But what is a fair amount for compensation? If there was a single set amount, it would be easy to determine what would have to be paid to ensure future care, but each situation is different and that is why you should read on for when your client might need a future cost projection.

Why You Need an Expert Report

Whenever you have a circumstance which is not well understood by the average person, then you need to have either an expert report or an expert witness. Because the jury in a trial will consist of average people who do not have comprehensive knowledge of the medical billing field, you will need an expert report.

In the case of a future cost projection, medical billing experts will look over what has been charged to the patient to date and what the reasonable cost of ongoing care will be. This, of course, depends on the region of the country and the nature of the care that the patient receives for their accident or injury, which is all the more reason to have an expert weigh in on the cost projection.

Because these costs are not standardized and do vary across the nation, having someone with a local office is important so they know what numbers they are working with when it comes to anticipating future costs for the person in the case.

Reasonable Certainty

Whenever there is an argument for future medical costs to be included in a settlement, there has to be a reasonably certain expectation that medical costs and care will continue into the future, such as physical therapy, assistance services, dialysis, or any other treatment that is crucial to the patient.

This is why it is important for medical billing experts to review the previous medical bills and expenses in order to determine what the patient is likely to pay moving forward.

Future Cost Projection

A future cost projection is different from a life care plan in a number of key ways, namely that a future cost projection is a much simplified version of what goes into creating a life care plan.

Where a life care plan will involve a medical record review and a consultation with a database to project future care costs like a cost projection, it will go more in depth and consult with several different providers of a service and determine the average cost of treatment in a vendor survey.

If it is applicable to the situation, a life care plan may involve interviewing family members and physicians in addition to the client to get a comprehensive picture of what their care situation will look like.

There are areas where a cost projection is the better way to go. While it may seem like the cost projection is the inferior of the two avenues to take, it is extremely powerful before the litigation as a threat of testimony from an expert along with evidence of the damages caused.

Future cost projections are not ideal for trial testimony, but the majority of tort cases, indeed, upwards of eighty percent of them, are settled without going to trial.

The reason future cost projections are not used more is that they typically require upfront costs in the form of having medical billing experts review the medical bills and other documentation and formulate the report. The previous medical bills may even be admitted into evidence depending on how the case is handled and can be used to form a solid basis for how much the client will need in order to maintain their care going forward.

This is weighed against the possible recoverable amount of money from the case, which is usually determined by insurance policy limits. There is only so much that will be reimbursed from an injury or accident, but they can help speed along the process of obtaining a settlement and in some cases obtain a higher settlement for the injured party.

In order to make the most of the argument that the future cost projections are reasonable and accurate, it is necessary to have medical billing experts who understand the healthcare market, what expenses are likely to be considered and awarded, and have them prepare their report accordingly.

Why You Need Medical Billing Analysts

It is highly recommended to hire medical billing experts to determine and testify to the reasonable value of medical service. The provider’s location can affect these costs and reimbursements.

Whether you are a plaintiff or a defendant in a case, one of the most important items in Automobile, Personal Injury, and Medical Malpractice cases is the cost of medical bills. Figuring out medical costs can be complicated, and expert guidance is critical to ensuring you have a clear understanding of what is “fair and reasonable” with regards to the finances involved in your medical care.

Medical Billing Analysts offers litigation support services nationwide, with offices in New York, New Jersey, Connecticut, Pennsylvania, Georgia, Florida, Texas, Nevada & California. Medical Billing Analysts represents both defendants and plaintiffs with regard to improper medical billing and coding.

The team of MBA professionals will review the hospital, medical and therapy bills to determine the value of past medical expenses and based on local CPT codes they can also perform a Cost Projection Analysis of future costs.  Through meticulous analysis, we can justify reasonable cost of services which assists in resolving the case.

Contact Medical Billing Analysts by phone or email at 800-292-1919 or intake@medicalbillinganalysts.com. We’re here for you, whether you need an evaluation of a single charge, or a complex injury case.