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Case study: Valerie Tate

Case study: Valerie Tate

Catastrophic & Risk Solutions

Valerie Tate was attending a nursing conference in Puerto Rico when she decided to take an evening stroll. While crossing a hotel driveway, a drunk driver struck her and pinned her beneath the vehicle. The driver briefly paused before rolling over her with the rear tires when driving away. The impact caused extensive internal injuries including organ contusion, nerve injury…

Case study: Bill Griffin

Case study: Bill Griffin

Catastrophic & Risk Solutions

Bill Griffin loved his job driving semi-trucks across the Midwest. During one routine delivery, a sudden gust of wind pushed his trailer into a collision with another truck. The devastating impact left him with a spinal cord injury, acquired brain injury, burns and other traumas. First responders did not expect him to survive and he was unrecognizable to his family…

Case study: Comprehensive Pain Management Network

Case study: Comprehensive Pain Management Network

Specialty Networks

After a fall on the job, the associate started having low back pain, as well as right lower extremity pain and paresthesias. His treatment included therapeutic intervention, passive modalities, and medication management.

Case study: Nancy Vanveldhuizen

Case study: Nancy Vanveldhuizen

Catastrophic & Risk Solutions

It was a beautiful fall day in rural Iowa and Nancy Vanveldhuizen was on her way to work driving past corn fields on a sparsely populated road. This bucolic scene radically changed when a gravel truck suddenly pulled out in front of her and caused a broadside collision. Remarkably she exited the vehicle on her own, but the outward appearance…

Case study: Surgical Implant Cost Management

Case study: Surgical Implant Cost Management

Specialty Networks

For this anterior posterior 360 lumbar fusion, Paradigm’s audit found that a disposable kit (i.e., supplies) billed as implantable hardware and that items implanted were found to be inconsistent with the procedure type.

Case study: Surgical Implant Cost Management

Case study: Surgical Implant Cost Management

Specialty Networks

For this open reduction internal fixation—radius, Paradigm’s audit flagged excessive charges and determined the accurate cost of all component parts billed was $550 (plus a 15% markup), as well as a non-implantable splint (DME) that was billed inappropriately as an implant.