MIEC’s Medical Practice Claims Prevention Surveys are a liability risk assessment service. They are for policyholders who request them and for physicians or group practices that have been selected to benefit from such surveys by MIEC’s Underwriting or Claims Departments. There is no charge to policyholders for this service. The surveys are intended to:

• Identify potential areas of liability exposure in the practice and offer constructive recommendations to eliminate or reduce the exposure.
• Evaluate the quality of medical record documentation and determine whether the records would assist or jeopardize a physician’s defense in litigation.
• Educate the physician about specific liability issues in his or her specialty and about laws affecting the delivery of medical services.
• Educate the physician’s office staff about loss prevention issues to adequately prepare them to perform services in a manner that protects patients and decreases the physician’s liability risks.
• Assess the risk of personal injury to patients or staff due to hazards on the premises.

MIEC recognizes the diversity of approaches in medical care and in interpretations of standards of care. Surveyors do not evaluate a physician’s competence or ability to practice medicine. Such determinations may be made only by other physicians.  No legal advice is given during the survey; legal questions are referred to an MIEC attorney.

MIEC’s Underwriting or Claims Department select the physicians who might benefit from a Claims Prevention Survey. Typically, those who receive priority are physicians who:

• Are new in practice;
• Have claims for which payments were made, or in which practice or procedural deficiencies (such as weak charting) adversely affected the disposition of the claims;
• Apply for insurance coverage and have been uninsured for a period of time immediately prior to their application;
• Request this service from MIEC.

In addition to the surveys for individual practices, Claims Prevention Surveys are conducted for group practices, multi-specialty practices, radiology departments, dialysis units, clinical laboratories, blood banks, outpatient surgery facilities, emergency departments, and urgent care centers.

Components of the Survey

1. Documentation review:  Before meeting with the physician or staff, the surveyor reviews a random sampling of medical records to assess the doctor’s charting practices. The criteria for review of medical records vary according to the physician’s medical specialty and type of practice.
   
2. Conference with the physician:  This 90-minute meeting provides physicians with an opportunity to ask questions about their practice and to learn about liability issues. Statistical information, articles and prototype forms are included in handout materials.
   
3. Conference with office staff:  This is a 60-minute discussion with the office staff to review liability issues, documentation, office policies and procedures, and ways to improve doctor-patient relations.
   
4. Policies and procedures:
   Information for patients:  The surveyor evaluates written information patients receive about the doctor’s practice, and about policies concerning billing, limitations on medication refills, on-call coverage when the doctor is not available, cancellation of appointments, and ways to educate patients about their responsibilities in the doctor-patient relationship.
   Staffing:  The surveyor reviews and discusses the duties of office staff.
   Scheduling:  Patient scheduling patterns are reviewed to determine if they are reasonable, if sufficient time is set aside for each patient visit, if patients wait too long to see the doctor, or if patients complain about waiting.
   
5. Premises inspection:  A walk-through inspection of the premises is conducted to identify and eliminate potential hazards that could result in injury to patients or staff.
   
6. Written report: We send a comprehensive summary of the survey findings and review of medical records. The report offers additional recommendations for reducing liability risks.

The Surveyors

MIEC’s Claims Prevention Surveys are performed by individuals experienced in claims management and loss prevention. If an evaluation of a physician’s clinical practice is required, MIEC will retain an independent medical consultant to participate in the survey.

To Request an Office Survey

Policyholders may request an office survey by completing and submitting the SURVEY FORM.  A loss prevention representative will call you to set a date for the survey.