Physical Therapy Peer Review

Guest Post by Susan Greenstein, Maryland Healthcare Clinics (MAJ Gold Sponsor)

In a recent District Court case involving several Maryland Healthcare Clinics patients, the defense counsel presented a “Physical Therapy Peer Review”.  This report was written by an “independent” physical therapist. The reviewer did not find anything improper with the treatment of the patients and agreed that the treatment was both necessary and appropriate and all modalities were correctly utilized. Instead, the author of the report chose to criticize the physical therapy charges.  This criticism was subjective and was not based on any published data. The reviewer simply elicited charges for various procedures by calling several unspecified providers in the Baltimore area. The reviewer did not provide the identities of the sources of his information or the names of the employees who were interviewed, their positions or qualifications. In fact, the reviewer did not explain the criteria used in selecting his sources.

At the request of the Plaintiff’s counsel Maryland Healthcare Clinics provided a detailed rebuttal to the peer review. It was explained that the physical therapy fee schedule used by Maryland Healthcare Clinics is based on the “Optum Customized Fee Analyzer”. This annual publication is a trusted industry tool used by both providers and insurance companies. It is recognized by the Maryland Boards of Physicians, Chiropractors and Physical Therapists. The Analyzer is based on scientifically compiled data and provides reliable benchmarks for setting fee schedules throughout the United States and specific geographical locations.

At trial, both the peer review and the rebuttal were admitted into evidence. Having considered both documents, the trial judge entered a generous verdict in favor of each plaintiff. According to Plaintiff’s counsel, the rebuttal played an instrumental role in the judge’s decision.

The staff at Maryland Healthcare Clinics is fully committed to providing the highest quality care to its patients. We stand behind our service and work closely with attorneys to maximize their clients’ recovery!