The Forest Hills IPA Inc. is a nationwide Individual Practice Association -- hence the "I P A" in our name -- of licensed mental health professionals and consultants. Established in 1987 by Dr. Leonard Grossman, FHIPA's ranks include psychiatrists, psychologists, neuropsychologists and related specialists in the field of mental health.
Much More than an IME Company
While FHIPA has performed thousands of insurance and disability related IMEs in the mental health arena, we are much more than an IME company. Each incoming case is reviewed, managed and supervised by a licensed mental health professional from start to finish. Our expertise in the mental health arena uniquely qualifies us to assist our clients in arranging clinically focused evaluations of the highest professional quality.
We are also familiar with testing strategies employed to assess malingering tendencies, and with difficult to document conditions such as CFS, somatiform disorders, and fictitious disorders. What's more, since we are a professionally managed company clients always have ready access to professional advice and consultation -- a unique and valuable service you can't get from a regular IME company.
Dr. Leonard Grossman
FHIPA accepts IME referrals in the mental and nervous arena for disability, no-fault, workers compensation, liability, and fitness for duty cases. We also offer forensic level peer reviews in the same areas. Our register of clients includes major disability and no-fault insurers, EAPs, IME companies, claims services, attorneys, managed care groups, disability management companies, and businesses.
A Professional IME Process
FHIPA offers clients a top-to-bottom, professionally managed IME process with a proven track record for fairly and objectively verifying both legitimate claims and for identifying cases of symptom exaggeration and malingering, which is often an issue in disability and workers compensation claims, liability litigations, and fitness for duty cases.
Our five step IME process may be summarized as follows:
Step One: Assessing the Records At no additional cost we will professionally review any mental and nervous case file sent to us to determine the specialty requirements for the IME examiner and the nature and scope of testing needed. A professional is also always available to consult with and discuss your case's special needs and requirements.
Step Two: Locating the Examiner We will locate the appropriate IME examiner from among our 2,500 member nationwide network of pre-screened mental health professionals, schedule the exam, and handle all records and payment arrangements through our central office in Sunnyside, New York. All our providers are rigorously pre-screened before IMEs are assigned. Each must be in clinical practice in their specialty and must provide proof of licensing and adequate malpractice insurance, have prior IME experience, furnish copies of Cvs and sample IME reports, and sign a statement that they are not currently charged with a misdemeanor or felony, and have not at any time been subject to\or notified of any pending disciplinary actions or ethics code violations.
Step Three: Formulating the IME Referral Questions When requested, we will prepare a professionally crafted individualized IME referral questions letter based on a careful review of the case file and with the input and approval of the referral source. We also translate any insurance or job-related issues and policy language into clinically formulated (and legally and ethically supportable) questions the examiner can directly and fully address. Professionally crafted IME questions letters help guarantee high quality reports which fully address the referral issues. The failure to submit a professionally crafted referral questions letter is perhaps the most serious deficiency in the IME process. On average, companies and vendors which use generic form letters, or have inexperienced non-professional staff members prepare the referral questions, get inferior reports which often contain unsolicited opinions and fail to adequately address referral issues.
Step Four: Review the IME Report A draft copy of each IME report is reviewed by a professional peer before it is signed and submitted to the insurer. IME reports must conform to Forest Hills IPA standards and guidelines, refrain from issuing clinical opinions outside of specialty areas, and also address any specific IME questions and issues submitted for consideration by the referral source.
Step Five: Convenient Billing and Provider Payments FHIPA's central office in Sunnyside, New York conveniently handles all records mailings, customer billing, and provider payments. All fees are payable to and collected by The Forest Hills IPA Inc., which in turn makes all payments to providers. There are no additional fees or charges beyond the agreed upon IME fee. Fees are confirmed to clients in writing by fax the day an appointment is scheduled. In cases where an exact fee cannot be quoted at scheduling time (not sure of testing requirements, size of file, etc.) we will quote a minimum and maximum fee range or an hourly rate.
FAQs and Understanding the IME Process
For additional information on the IME process, and for answers to frequently asked questions on psychiatry, psychology, and neuropsychology, visit our FAQ page. If you work in the insurance field and handle psychiatric disability claims, I particularly recommend checking out The ABC's of Managing Psychiatric Disability Cases.
"ABCs" is an on-line version of an FHIPA publication written by Dr. Leonard Grossman and adapted for the web by Mr. Michael Castellano. Part One on Specialty Information furnishes plain language definitions of psychiatric, psychological, and neuropsychological IME practices, professional responsibilities, and procedures. Part Two, Managing Psychiatric Disability Cases, is of special interest to insurance disability consultants, and details cost effective strategies for managing cases and coordinating and fine-tuning the IME process.
Additional Information on Malingering IMEs
As we have already mentioned, malingering is a frequent concern in mental and nervous cases. Malingering can be difficult to identify given the inherently subjective nature of patient self-reporting as to their functional abilities and limitations. It is also important to understand that malingering should not to be confused with those who are faking or fabricating a mental illness. The difficult question which needs to be answered by the IME examiner is often not whether or not there are psychiatric difficulties, but rather do those difficulties rise to a level that renders the individual unable to function in a work environment?
Malingerers are often individuals who have had or continue to have psychiatric difficulties, but for purposes of secondary gain exaggerate them or fail to report improvement from formerly disabling levels. It is both our professional and case management opinion that all mental and nervous IMEs should incorporate and include psychological and/or neuropsychological testing to corroborate the veracity and severity and scope of reported symptoms.
We take this position based on the fact that without objective data obtained via such testing, all the examiner has to rely on are claimant self-reports and the clinical records of the care givers. Professional reality dictates that an IME examiner will find it difficult to overrule both the opinions of care givers and self-reports when only given the opportunity to briefly interview the claimant.
Timely Professional Services and No Fee Scheduling In closing, I would like to again remind you that all incoming service requests are confidentially handled -- from beginning to end -- by a licensed mental health professional. What's more, we'll never keep you waiting on the phone: FHIPA clients have immediate professional access during regular business hours. We're always available to discuss a case or assist in determining your precise IME needs and requirements. In most cases, we can arrange your IME anywhere in the continental United States in less than 48 hours.
You'll also be pleased to hear that there's never any consulting fee for your initial intake consultation, and no fee for locating examiners and scheduling IMEs. If you'd like more information on FHIPA services, or have a case you wish to discuss, simply pick up the phone and give us a call.
Sincerely,
Leonard Grossman Ph.D.,
President, The Forest Hills IPA Inc.
Diplomate, The American Board of Forensic Examiners
Nationwide Services
Peer Reviews & Consulting
Includes full documentation of all records reviewed and detailed professional reporting on diagnostic validity, treatment efficacy and appropriateness, apparent degree of disability, severity of reported symptoms, back-to-work prognosis, and recovery potential.
Depending on the reported diagnosis, reviews are conducted by a licensed psychiatrist, psychologist, or neuropsychologist. FHIPA consultants are also available to discuss review findings and follow-up case management recommendations.
Available for disability, no-fault, workers compensation (including New York), liability, and fitness for duty cases.
Psychiatric, Psychological & Neuropsychological IMEs
Includes record review and a full listing of all records reviewed, extended interview time when authorized, administration of psychological and/or neuropsychological testing when requested and indicated, detailed responses to all referral issues and questions, and peer review of a draft report before submission.
Available for disability, no-fault, workers compensation (including New York), liability, and fitness for duty cases.
Malingering Assessments
Available in mental and nervous cases, and typically performed by either a clinical psychologist or neuropsychologist. We will advise clients regarding the type of testing required and its estimated scope. Includes record review and a full listing of all records reviewed, extended interview time when authorized, administration of psychological and/or neuropsychological testing when requested and indicated, detailed responses to all referral issues and questions, and peer review of a draft report before submission.
Available for disability, no-fault, workers compensation (including New York), liability, and fitness for duty cases.
Hard to Find Doctors IMEs
While our main specialty still resides with mental and nervous cases, FHIPA now offers selected customers IME scheduling services for other clinical and medical specialties. Please call (718) 786-1328 for more details on eligibility for this service.
Available for disability, no-fault, workers compensation (including New York), liability, and fitness for duty cases.
A Partial List of Clients
Cigna Group Insurance, CNA Insurance Company, Kemper National Services, Marathon Ashland Petroleum, Medical Life Insurance, The Hartford Insurance Co., and Wausau Insurance Co.
In closing, I would like to again remind you that all incoming service requests are confidentially handled -- from beginning to end -- by a licensed mental health professional. What's more, we'll never keep you waiting on the phone: FHIPA clients have immediate professional access during regular business hours. We're always available to discuss a case or assist in determining your precise IME needs and requirements. In most cases, we can arrange your IME anywhere in the continental United States in less than 48 hours.
Peer Reviews & Consulting 