Founded in 1991 as The Physician Network, TPN has grown and expanded from an independent medical evaluations (IME) company to providing a comprehensive suite of forensic medical claim services. Our team has the experience and knowledge to forensically review and analyze all types of claims including worker’s compensation, automobile accidents, medical malpractice, disability, general liability and other claims involving even the most complex of injuries, including traumatic brain injury, spine and multiple limbs, substance abuse, and other injuries.
Recognized as the leading ‘go-to’ forensics provider in the U.S. to investigate, analyze and resolve high exposure and complex medical claims, TPN works with leading insurance providers, corporations, government agencies and law firms to provide unbiased and evidence based data and recommendations on their costly and challenging cases, enabling our clients to successfully negotiate and close claims or support defense teams with credible trial witnesses.
The average dollar value of claim settlements and potential fraud has continued to rise while insurance carriers face declining premium rates and increased medical costs. Although many claims are settled quickly by adjusters or their service providers, insurers struggle with claims involving complex / multiple injuries or other challenges. Costs can quickly skyrocket, and if settled without proper forensic review and analysis, could be costing insurers millions more than necessary and impacting their bottom line.
“My first contact with TPN was to get help on a complex medical fraud case. Their ability to immediately understand the issues and deliver unbiased, factual results made his company standout among the cookie cutter IME/peer review industry. TPN provides great value and understands medical issues from all lines of insurance. I have since used TPN on many cases and their CEO has consulted for us to provide workflows and business processes to streamline our claims review process. If you have a claim issue or really want to make an impact on leakage as it related to medical claims in disability, P&C, commercial, or life, then TPN is the only company you should call.” – Dennis Toomey, former Insurance Fraud Solutions Architect for SAS
In addition, IMEs and other claim review services require physicians to render medical opinions without providing proper knowledge or claim documentation, or allow the required time it takes to review or conduct an exam on more complicated claims. This can result in medical reports with inaccurate assessments or lack of evidence for insurers to make decisions that can resolve claims and reduce their cost exposure.
TPN’s team conducts file audits and document discovery and analysis to develop a road map to resolution and can identify the appropriate services and experts to bring in on the case. TPN ensures every expert assigned to the claim are qualified and informed to successfully conduct in-depth and unbiased reviews and exams. TPN delivers medical reports that are clear, concise, and evidence-based, substantiating decisions to close the claim. If needed, our experts can back up their opinions in court, helping defense teams should the claim go to trial.
TPN’s Mission is to ensure claimants receive reasonable, medically necessary, and causally related medical treatments while minimizing indemnity exposure for our clients.
Our Core Values
Our team embodies a set of core values—integrity, respect, excellence, and creativity—that serve as the cornerstones for our interactions with each other and customers and enable us to deliver value for every claim. We are committed to the highest standards and ethics, staying fiercely focused on outcomes that matter to our customers.
- Integrity: The core being of our culture. We do what we say we will do. We are honest, truthful, and fair about WHAT and HOW we do business. Our forensic process is transparent, so customers understand and agree to the approach and services recommended for each claim.
- Respect: We listen to our customers and tailor our approach to produce outcomes that align with their expectations.
- Excellence: We are passionate about success, and relentless in our pursuit of evidence to help our clients resolve complex and costly claims as efficiently and effectively as possible.
- Creativity: We are adaptive, proactive, and determined to get to the facts. We strive to constantly improve and reinvigorate our customers and our business with new ideas, methods, services, and training to continually deliver more value.
The TPN leadership team and Network of Experts is extensive and diverse, with the knowledge and skill sets to provide the best forensic services required for even the most challenging claims. We provide file audits with document discovery, in-depth medical and investigative reviews and exams, producing evidence-based medical reports, as well as credible trial witnesses if necessary.