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As the country navigates through the pandemic and grapples with what the rest of this year has in store, a constant for law firms and their clients is the need to prioritize and manage many competing agendas while ensuring case development costs remain within budget.

Thankfully, from a medical record review standpoint, it is possible to control costs without sacrificing quality. Below, our nurse team shares their five tips on how to do so:

Define Objectives for the Work Product

Prior to initiating medical record review and analysis, it is essential that the objectives, or “use case”, of the work product report be considered. For example, is the objective to simply verify if evidence of exposure exists relevant to the allegation of injury, perhaps as an early case assessment strategy or, conversely, is a complex and detailed analysis and reporting of facts, including any alternative causation and mitigating factors, required? Before assuming detailed and potentially costly case analysis is required, assess various work product development strategies and options relevant to the current objectives, and consider if a phased case work-up approach can be implemented to contain case development costs. An experienced legal nurse consultant is a valuable partner while assessing and planning the strategy for case development. In addition, the cost of outsourced legal nurse consulting services is proven to be a more affordable option compared to hiring for in-house review or engaging a physician expert when physician services are not yet required.

Know Your Budget

Prior to beginning the work product development, it’s essential that you confirm the budget required. Start by obtaining a cost estimate from the nursing team, including cost drivers and assumptions to ensure you have clarity regarding the estimated case costs, and then confirm the plan and budgetary requirements with your client. This process will help provide a clearer picture of what is truly needed for your case and ensure alignment regarding strategy before work begins. Then, share your budget approval and any cost concerns with your nurse team. They can customize a work product template that aligns with your budgetary requirements, as well as regularly notify you when the cost of work approaches certain dollar amounts. This not only keeps you updated from a cost perspective and allows for early adjustments, but it also prevents any unhappy surprises during invoice review.

Engage Early

The sooner you engage an experienced legal nurse consultant or nurse team for your litigation, the sooner you can benefit. Early engagement of legal nursing expertise provides insight into three key areas:

• The strength of the case
• Recommendations for additional relevant discovery actions
• A preview of potential arguments that the other side may bring up

These can all influence case strategy and, ultimately, the cost of your litigation. Engaging a legal nurse consultant early can also cut down on additional fees. For example, if you wait too long to retain a nurse consultant and need work product completed in a matter of days, chances are you could be charged a “rush” fee for the short turnaround time, in addition to the nurse’s regular fees. This extra cost is never appreciated by your client– especially if it could have been avoided in the first place.

Don’t Over-Complicate the Work Product Format

Prior to beginning work, a nurse consultant will meet with the attorney team. This meeting is essential to gain information on the litigation and learn what the law firm is looking to achieve and focus on. Whatever the directive, the nurse consultant will then customize the client’s desired work product report template. However, it’s important to remember that over-complicating the report format template can result in increased case cost. For instance, incorporating tables and charts into a work product can be time-consuming for a nurse to construct. It adds to the total case development time, and thus, the total cost of the review. A good rule of thumb, then, is to keep it simple depending on the use case! If variable or complex formatting isn’t absolutely necessary for the work product you require, leave it out.

Make Sure Your Record File Includes Key Providers

Before starting a full case work-up, and depending on the objectives of the work product, it is often more cost effective to ensure the most critical, “key provider” records are included. Receiving key medical care provider records after the rest of the medical record files have been reviewed can impact a nurse’s initial findings and analysis and require significant work product re-work that would increase their review hours and, again, increase your total cost.

Whether needing to explore potential strategies, assess the strength of a particular allegation, or develop a deeper understanding of the medical facts, an MRC nurse can help attorneys prepare their case and defend their client with confidence – all while staying within budget. To learn more about how we are committed to controlling your litigation costs, visit


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