12 Ways to Earn Extra Income From Medical Activities

Leigh Page

Disclosures

December 17, 2013

In This Article

The World of Insurers

6. Review Health Insurance Claims

Reviewing insurance claims is another part-time job that can be done at home or just about anywhere. Your work will be delivered to you electronically by an independent review organization (IRO).

IROs are unbiased, outside companies that health insurance companies engage to address concerns that they might be improperly denying claims, says Heather Fork, MD, owner of Doctors Crossing, a career-consulting firm for physicians. The National Association of Independent Review Organizations, which represents these groups, provides a list of IROs on its Website.

"All of this work can be done online," says Barry Korn, MD, national medical director of one of the IROs, Concentra Physician Review, based in Addison, Texas. Dr. Korn says a few hundred physicians work for Concentra as part-time reviewers. These doctors determine the medical necessity of coverage requests that have been flagged by Concentra's nurse reviewers. These doctors also perform more extensive reviews that involve looking back over the treatment for a particular patient for an extended period, he says.

Dr. Fork says IROs usually pay $85-$200 or more per hour. Dr. Korn says Concentra's payments range from $100 to $150 an hour or more, on the basis of the physician's qualifications and specialty.

"Physicians who do this work need to be prompt, accurate, and reliable," Dr. Fork says. "These companies often want a 24-hour turnaround." They have to meet deadlines they have made with the insurance companies. "Many IROs also require some degree of continued clinical practice," she adds.

"If there is insufficient information in the clinical record, the reviewer calls the physician to have a peer-to-peer conversation," Dr. Korn says. "The call basically has 2 purposes: to obtain information and to educate the physician on current evidence-based guidelines."

To obtain this work, Dr. Korn says physicians need to fill out applications, which go through a rigorous credentialing process that takes a month or two. If accepted, the physician starts with online training at home.

Pros: You can do this work at home and make decent money.

Cons: There may be some tight deadlines that can put pressure on your schedule.

7. Examine Patients for Insurers

Physicians can perform independent medical examinations (IMEs) part-time, but be forewarned: You'll be performing a history and physical examination that is very different from what you do with your own patients. Don't expect a warm and cozy relationship with the person you're examining. You will be trying to establish whether this person merits a payout for worker's compensation, auto insurance, health insurance, or Social Security.

In some cases, patients may be hiding some aspect of their physical condition so that they can qualify for a payout, says David P. Kalin, MD, a family physician and IME in Oldsmar, Florida. If that is the case, the physician doing the IME will try to uncover it. "You don't just do a simple history and physical [examination]," Dr. Kalin says. "You have to be pretty thorough about it."

"I've being doing IMEs for quite a long time, and it's a good business," he says. His fees range from as little as $100 an hour for a Social Security examination to $500 an hour for private payers. The IME work involves about one quarter of his professional time. He says some cases can take him an hour or two of work, whereas others take a full day.

"The way you write your report has to be geared to the way a lawyer thinks," Dr. Kalin says. For example, if the doctor reports that the patient's medical condition was "exacerbated" by a car accident, the patient will probably get very little compensation. But if he reports that it was "aggravated" by the accident, "there is money around that," Dr. Kalin says.

Learning this new medical language and understanding the goals that physicians doing IMEs are supposed to meet requires training. Dr. Kalin advises taking some courses approved by the American Board of Independent Medical Examiners (ABIME) and then getting ABIME certification.

Physicians seeking IME work can contact worker's compensation, auto insurers, and other companies and agencies. Many state worker's compensation programs, such as those in in Washington and New Mexico, require IME physicians to be approved by the state. SEAK, the expert witness training company, also works with IME physicians and provides a national directory of IME physicians on its Website.

Some companies, such as Scope Medical in Stoneham, Massachusetts, engage physicians for IME work. Scope Medical says that physicians typically examine 6-10 patients at a time at a Scope facility, following a specified format.

Pros: Payments can be generous, and you can create your own schedule.

Cons: The people you examine may feel antagonistic toward you.

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