Providing Insight Into Medical Claims has been our business for over 22 years. The Physician Network.

1. Providing Insight Into Medical Claims
Founded in 1991, The Physician Network, Inc. (TPN) started out as an independent medical
evaluations (IME) company simply coordinating examinations and general medical record review
services. Over time, we learned that the typical cookie­cutter approach to the IME and File
Review process was contributing to the IME/IMR report losing its value. In fact, the typical
IME/IMR report in many circles are no longer viewed as being “independent” and have been
reduced to serving only as a negotiation tool for settlement purposes instead of a valuable
claims decision making tool that it can and should be.
Meanwhile, the average dollar value of claim settlements – along with insurance fraud – has
continued to rise while insurance carriers face declining premium rates. This has created undue
pressure on claims staff to cut costs (including looking for even cheaper IME/IMR services,
which has only served to worsen the problem). As we began to recognize these developments,
we evolved into a medical consulting firm providing specific services designed to help our clients
meet these challenges (more complex cases, pressure on expenses, etc.).

2. In addition to the above challenges, one of the biggest issues we see facing the insurance
industry today is physicians rendering medical opinions about claims without enough knowledge
or understanding of the various types of insurance and the numerous state laws governing each
of them.
Too often, medical reports are written without a clear understanding of these issues, resulting in
inaccurate assessments causing unnecessary delays in claim processing, which frustrates
everyone involved and adds to the cost of administering a claim. TPN has shown that by simply
teaching a physician to use proper terminology for the specific claim type and state of loss can
make the difference between the acceptance and denial of a claim. This is why we match our
clients with physicians knowledgeable about both the claim type and the state of loss for each
case and then work with those medical experts to produce a clear, relevant, and substantiated
medical report.