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Medical Charge & Necessity Review — MCNR Both Sides

Medical Charge & Necessity Review — Are the Claimed Specials Defensible?

A physician-authored review of whether the medical special damages in a claim are clinically necessary, related to the injury, correctly coded, and reasonable in amount — evaluated the way a payer-side reviewer would. Not a billing audit: necessity, relatedness, coding integrity, and charge reasonableness in a single physician work product.

From $450 · Memo, standard, or comprehensive scope · Non-testifying work product
Founder’s Advantage

A billing analyst can say a charge is high. A treating physician can say a treatment was necessary. Neither does both — and neither has sat on the payer side deciding what actually gets allowed. Our founding physician applied InterQual and MCG criteria to 3,000+ US payer-side claims. The MCNR brings that single perspective to the medical specials: whether each service was clinically necessary, whether it is related to the pleaded injury, whether it is coded consistently, and whether the charge is reasonable against benchmark data — in one source-referenced review rather than stitched together from a coder and a doctor.

Defense framing — Billed-Charge Exposure Review

For defense firms, TPAs, and carriers, the same methodology runs in reverse: identifying medically unnecessary, unrelated, inflated, miscoded, duplicative, or weakly supported charges before settlement posture is set, with a documented reasonable-value range for reserve and negotiation. Same destination, same physician, conflict-screened on a separate matter.

What the MCNR answers

Clinical necessity: Was each service supported by the record under the documentation-threshold logic payer reviewers actually apply?

Relatedness to injury: Is the service attributable to the pleaded mechanism, or to pre-existing or unrelated pathology?

Coding integrity: A physician-led screen for unbundling, upcoding, duplicate, or unsupported line items inflating the total — not a certified coding audit.

Charge reasonableness: How do the charges compare against benchmark data for the same service in the same geography?

Reasonable-value range: What portion of the claimed specials is clinically and economically defensible?

Best used when

  • Specials are the fight

    The injury is not seriously disputed, but the dollar value of the bills is — which describes most PI and bad-faith matters.

  • Before you set your number

    Plaintiff teams substantiating specials before demand; defense and TPAs scoping exposure before reserve or mediation.

  • Inflated or padded billing suspected

    Over-utilization, surprise line items, provider-lien billing, or charges well above the local market.

  • Pre-existing or unrelated overlap

    Degenerative or prior-injury pathology that complicates which charges belong to this claim.

Starting Fee
$450
Leverage memo
Turnaround
3–15 days
By scope
Output
Memo → full
Physician-authored

Advanceable as a case cost and recoverable at settlement in contingency-fee matters. See the full rate card →

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

Request a Charge & Necessity Review →
Methodology & data

How the reasonable-value range is built — and why it holds up

Necessity & relatedness

Each contested service is assessed against the same documentation-threshold logic used in payer utilization review (InterQual / MCG-style criteria), then tested for attribution to the pleaded mechanism versus pre-existing or unrelated pathology. This is the layer a billing analyst cannot reach.

Coding & charge benchmarking

Line items are checked for unbundling, upcoding, duplication, and support in the record. Where engagement scope and available data allow, charges may be benchmarked against available charge and allowed-amount references, CMS fee schedules, hospital price-transparency data, payer-allowed logic, and other jurisdiction-appropriate market references — to express a defensible reasonable-value range.

A distinction we keep explicit

Billed, allowed, negotiated, Medicare, and tort “reasonable value” are five different numbers. The review states which benchmark anchors each opinion and why, rather than collapsing them — because that distinction is exactly where a poorly built charge opinion gets excluded.

The MCNR is delivered as physician-authored, attorney-directed consulting work product (non-testifying). For matters requiring a sworn affidavit or trial testimony specifically on charges, we coordinate with a US-credentialed coding/billing expert (CPC/CIC/CPMA) so the testifying layer is held by the right credential.

Scope & pricing

Three depths, one method

TierScopeStarting feeTurnaround
Settlement Leverage MemoSingle-provider or quick exposure read; non-testifying negotiation supportFrom $4503–5 business days
Standard ReviewMulti-provider, single episode of care — the core deliverableFrom $1,2005–10 business days
Comprehensive ReviewCatastrophic, surgical, or high-volume records; full reasonable-value rangeFrom $3,00010–15 business days

Final fee confirmed at scope before records are transmitted; depends on record volume and number of contested providers. Rebuttal of an opposing party’s bill or damages analysis is available as an add-on.

Pairs with

Often run alongside viability and reserve work

Plaintiff teams pair it with Case Viability Screening and the Full Intelligence Report. Defense and carriers pair it with Medical Reserve Analysis.

Plaintiff Specimen → Defense Specimen → All MCNR Samples

The specimen uses fictional clinical & billing data. No PHI. Live reports are calibrated to the records and jurisdiction of the matter.

Know what the specials are really worth.

No PHI required to start.

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