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Premium Add-On · Standalone Available

Defense Medical Lens™

Before mediation, the defense will have a medical theory of the case. This shows you what it is — built by a physician who has performed that exact review function across 3,000+ payer-side US claims. Defense firms, TPAs, and carriers use the same analysis from the other direction: physician-grounded medical exposure to set accurate reserves and support defensible settlement authority before the mediation date.

From $400 add-on · $950 standalone · 48 hrs add-on · 3–4 days standalone
Founder’s Advantage

The Defense Medical Lens is not a hypothetical simulation. It is calibrated against InterQual, MCG, and the medical-necessity logic that defense reviewers and payer-side reviewers operate under — because our founding physician has performed this exact review function across 3,000+ payer-side US claim reviews, applying InterQual and MCG criteria under real claims conditions. When we map “likely defense medical pressure points ranked High to Low,” we are applying the same analytical framework, applied first-hand on the payer side.

Six components delivered

  • 01
    Ranked Medical Pressure Points

    Likely defense medical arguments ordered High, Moderate, Low-Moderate, Low. You know exactly which vulnerabilities the defense will lead with.

  • 02
    Causation Vulnerability Assessment

    Where the causal connection is strong in the record, and where it is most exposed to challenge.

  • 03
    Treatment Necessity Analysis

    Payer-style medical necessity evaluation of each major treatment category — exactly how a defense reviewer would evaluate each procedure.

  • 04
    Pre-existing Condition Exposure

    The weight the defense medical position is likely to place on prior disease — and what documentation could reduce it.

  • 05
    Functional Impairment Documentation Review

    Whether the record supports the disability picture across providers — where documentation is consistent and where it creates exploitable gaps.

  • 06
    Documentation Action List

    Physician-authored list of documentation that may reduce the strength of likely defense medical arguments before mediation.

Best for

Cases approaching mediation, settlement conference, or demand preparation — ideally 30 days before the mediation date.

High-bill soft-tissue and surgical recommendation cases where the defense will challenge treatment necessity aggressively.

Cases with significant pre-existing condition exposure where the defense is expected to attribute pathology to baseline degeneration.

Defense firms, TPAs, and carriers setting pre-mediation reserves or confirming settlement authority — physician-authored medical exposure analysis creates a documented, defensible basis for reserve decisions that a claims adjuster cannot produce from medical records alone.

Add-On
$400
Added to any engagement
Standalone
$950
3–4 business days
Add-On Speed
48 hrs
Mediation date required

Advanceable as a case cost and recoverable at settlement in contingency-fee matters. Bundle with IME Deconstruction from $800 →

Defense & institutional buyers: Invoiced at scope confirmation. Net 15 terms. Retainer arrangements available.

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Specimen Deliverable

See a full Defense Medical Lens™ report

Ranked pressure points, causation exposure, documentation action list. Pre-mediation specimen. Fictional data.

View Sample → All Samples

Know the defense medical theory before mediation.

Built from first-hand application of payer-review methodology.

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