Terms & Conditions

Terms & Conditions

MIDWEST ORTHOPAEDICS AT RUSH LLC - Terms & Conditions

  • Independent Medical Evaluation (IME)
  • Permanent Partial Impairment Rating (PPI)
  • Second Opinion, Evaluation and Re-Evaluation
  • Medical Record Reviews (MRR)

I. SERVICES

MOR physicians agree to provide the following services to CLIENT:

  1. Independent Medical Examinations (IME)
  2. Second Opinions, Evaluations, and Re-Evaluations
  3. Permanent Partial Disability Impairment Ratings (PPI)
  4. Medical Record Reviews (MRR)

II. MOR RESPONSIBILITIES

A. MOR will provide centralized scheduling/contact persons to assist with:

  1. Finding the most convenient location available for the IME.
  2. Scheduling with a Board-Certified IME credentialed physician with the appropriate sub-specialty.
  3. Scheduling Impairment Ratings with physicians utilizing the 6th Addition AMA Guidelines.
  4. PPI Ratings can be scheduled independently or in conjunction with the IME with separate reporting.
  5. Arranging the appointment and sending notification of the time, physician, and location of the appointment.
  6. Handling problems and issues promptly and efficiently through our Midwest Orthopaedics at Rush Scheduling and Customer Service teams.

B. MOR staff will schedule IME or PPI appointments within 24 business hours as follows:

  1. 7-14 days for the first available orthopedic specialist (other specialty types of availability may vary)
  2. Date specified or specific physician at earliest available open slot in practice schedule.
  3. Will make every effort to accommodate specific requests or make acceptable alternate suggestions.

C. MOR will facilitate timely IME / PPI Rating Reports:

  1. A quick report will be provided within forty-eight (48) hours if requested by Client.
  2. IME Detailed Reports available will be made available within ten (10) business days.
  3. PPI Ratings Reports will be made available within ten (10) business days.
  4. MOR will send an agreement for IME pre-payment at time of scheduling and payment must be received within 14 days of appointment date (if applicable).
  5. MOR will advise IME patients to bring a photo ID.

D. Record Reviews are billed at $1,250 per hour in 15-minute increments. 

  1. MOR’s WC Scheduling Department creates and maintains appointments for in-person visits only.
  2. Administrators for the individual practices will field requests for MRRs directly from the WC Scheduling Department and provide a completion date based on doctor availability. 

III. COMPANY RESPONSIBILITIES

  1. The client will provide the IME physician with the patient's medical record at least 2 weeks before (if possible) the scheduled appointment date by a traceable method.
  2. The client will require IME patients to bring a government-issued photo ID to the appointment.
  3. The client will pay for services in the timeframes stipulated in this agreement.
  4. The client will provide a third-party professional interpreter if the patient does not speak English or if the provider does not speak the client's native language.

IV. PAYMENT TERMS AND FEES

A.  IME, Re-Evaluation, Second Opinion, and Evaluation exams:

  1. Standard IME charges are based on specialty
    Orthopedic $1,300
    Hand $1,500
    Spine $1,700
    PM & R $1,800
    General surgery $2,000
    Neuropsychological $2,500
    Psychological $4,200
  2. A standard IME is an IME for a single body part.
  3. The standard IME pricing includes up to 1 inch (200pp) of medical records. Records over 1 inch (200pp) will be subject to the additional records charges of $1,250 per inch in quarter ¼ inch increments.

B. Permanent Partial Impairment (PPI) Rating:

  1. The standard PPI rate is $1,200 for the initial body part and $300 for each additional body part. 
  2. In conjunction with an IME, the rate is $600 for the initial body part and $300 for each additional body part. 

C. Addendums after the patient is seen are billed at $1,250 per hour in 15-minute increments.

D. Record Reviews are billed at $1,250 per hour in 15-minute increments.

E. Other Terms:

  1. Prepayments must be received at least 14 days in advance of the scheduled service date.
  2. Contracted/previously agreed upon IMEs (in addition to addendums, and PPI charges) will be invoiced after the service date.
  3. For each additional body part for an IME Only add $300 (unless spine then add $350)
  4. For each additional body part for an IR Only add $300.
  5. For each additional body part for an IME + IR add $600 ($300 IME + $300 IR).
  6. Excessive record review, X-ray and DME charges incurred at the time of service will be invoiced separately after the service date.
  7. Addendums will be sent to the client once payment is received or subject to previously agreed-upon terms.
  8. Invoices must be paid no later than 30 days after invoice receipt.
  9. All services rendered are expected to be paid.
  10. A cancellation or no-show fee charge of one IME body part applies if the appointment is canceled less than 2 business days before the scheduled time or if the patient does not show up for the scheduled visit. If records exceed that which is otherwise included for purposes of the IME for a single body part, additional record review charges of $1,250 per inch (200pp) in quarter-inch increments may be billed in addition to the cancellation or no-show fee.

V. APPOINTMENT SCHEDULING

IME / Workers' Compensation Appointment Scheduling Department

Scheduling Hours

Monday - Friday 7:00 AM to 5:00 PM

To schedule an IME or Workers' Compensation appointment call 708-236-2783 or email workcompscheduling@rushortho.com.

VI. REMITTANCE ADDRESS

IME Financial Department

1 Westbrook Corporate Center #240, Westchester, IL 60154