As an expert in his field, Dr. Humberstone performs Chiropractic Peer Reviews and Independent Medical Examinations for many vendors, third party payers, physicians and attorneys. He can also provides Private Chart Reviews for other Chiropractic Physicians in search of quality assurance.

Dr Humberstone also provides Private Chart Review: contact our office at (630) 529-2225. Our Office Manager will provide you with additional details. Our services are customized to your needs.

Utilization Guidelines

Guidelines should represent reasonable and appropriate treatments for optimum recovery.  Each has its own specific parameter depending upon the clinical circumstances.  Treatment should be based on Patient Needs, and Sound Medical/Chiropractic judgment but some cases fall outside these guidelines. When cases fall outside these guidelines the physician must take extra care to document complicating factors in which recovery is longer than the natural course.

(If you need full case review and are wiling to work with a vendor these companies can be contacted)   Review companies Dr Humberstone has worked with:

Medical Necessity Review

A Medical Necessity Review, performed by Dr Humberstone will, evaluates the care of the claimant to determine what medical care is supported by the evidence to treat the conditions documented in the clinical record. A Medical Necessity Review is performed for the preliminary review of a claim or conducted in the event of an appeal. Evidence-based factors are utilized to support the validity and severity of diagnosis. The comprehensive review is based on the claimant's collective medical records and if requested a peer-to-peer consultation via teleconference between the reviewing and treating physicians. The Medical Necessity Review includes a clinical summary, explanation of assessment and the authoritative medical sources and evidence referenced to certify the request for services that are warranted.

Peer File Review

A Peer File Review includes a clinical summary, explanation of assessment and National publicized Peer Reviews Evidence Based Guidelines references to ensure that the conditions being treated are treated in accordance with established standards of medical care.Peer file reviews provide accurate diagnoses and treatment protocols that identify necessary and unnecessary spending, avoiding wasteful or unnecessary medical expenses.

Independent Medical Examination (IME)

An independent medical examination provides anhistory physical examination as well as a review of the records of the claimant's current status of function/disability, prognosis,recommendation on further treatment, maximum medical improvement and work status.

Disability reviews

When the time Off Work goes beyond the expected a review of the documentation for the support of off work may be necessary.

FLMA reviews

When there are question, the documentation need to support leave.

Private Chart Review for the Provider

Private Chart Reviewed are for the private practicing chiropractor to point possible RED FLAGS in  the providers documentation. Dr Humberstone will, evaluates the record of the claimant to determine what medical care is supported by the evidence to treat the conditions documented in the clinical record. Having good documentation can help avoid a review  Evidence-based factors are utilized to support the validity of the record provided.