• 15 Years of industry experience.
• Founded Expert Review, Inc. 1998.
• Pioneered the PIP record review/bill audit.
• Handled injury claims as an adjuster.

Our Company Philosophy
Founded in 1998 in response to a need for the joining of a quality medical review product with excellence in customer service, ERI today works with an expanding network of independent, practicing physicians and dental specialists to provide thorough and professional medical and dental reviews for the majority of Massachusetts insurance companies and their defense firms.  Our reviews are thorough, our reports are timely, and we pride ourselves on our ability not merely to meet your needs but to exceed them.

Why Are Peer PIP Reviews So Important

• They help reduce fraud
• They keep PIP payouts on a more reasonable scale.
• They keep medical providers honest.
• They insure policy integrity.
• Stabilizing premium rates.
• They set precedent for what is reasonable & appropriate treatment.
• They can help with both adverse PIP as well as BI settlements.

How Can We Help In This Process

• We can assist the claims handler in preparing the file for review such as copying all medical and other associated material.
• We can notify treating providers of any missing or necessary documents that are needed for review.
• Our experienced staff can answer any questions you may have in regard to what is needed for review.
• Personal file pick up from an ERI representative on a weekly or as needed basis, rush cases are no problem.

Be Sure That Your Expert Is Just That!
All of our reviewing physicians are in active practice, board certified, licensed and willing to testify if necessary.  Many of our reviewers are affiliated with the top rated Hospitals in Massachusetts.  Some have chaired on the Massachusetts Physical Therapy Licensing Board. Some of our Chiropractors have served or are currently members of the Massachusetts Chiropractic Board.  We also work with the doctors that work with the Pros :

• Boston Celtics Orthopedics, Boston Bruins Radiology, N.E. Patriots Radiology.

       What Is Needed For A Strong Review
A complete compliment of the medical records and associated billing, including initial evaluations and re-evaluations.

• Emergency room records (if available).
• Police reports (if available).
• Vehicle appraisals and photos
• Any X-ray or MRI reports
• Prior medical records (if possible)

Are Pip Peer Reviews Actually Working

• Our numbers show an average of 53% bill reduction per case.
• Less than 5% of reviews are going to trial.
• Roughly 95% of these are either being negotiated or going away on their own.
• We have an 80% or greater success rate when defending in court.
• Savings is good for both Insurer and Insured.

Peer Review Vs. IME

• Reviews look at entire picture; records, photos, police reports, ect. and base opinion on their validity, IMEs not so much.
• Reviews are performed peer to peer, IMEs generally are not.
• Reviews provide a medical bill audit to define payment parameters, IMEs do not.
• Reviews are like watching a video from start to finish (extremely informative), IMEs are like a single snapshot (very limited).
• Reviews can comment and conclude causal relationship issues via mechanism of injury, IMEs can not.

When Should A Peer Review Be Considered

• On all soft tissue injuries where damage to vehicle (s) is minimal.
• When all involved parties treat for exact same injury and length of time.
• If treatment to a minor begins without a Pediatric referral.
• Red Flag providers rear their ugly head.
• Claimant has history of multiple injury claims.
• Excessive Diagnostic testing for soft tissue injury.
• Large gap between DOA and initiation of care.
• Multiple claimants.