Medical-Legal Fee Schedule (MLFS) Best Practices: ML200

Below are some best practices to ensure you have the right supporting documentation to get your med-legal bills paid.

To schedule an evaluation through Simplexam:

Scenarios to charge for a Missed Appointment (ML200):

Supporting Documentation needed for a Missed Appointment:

In the scenarios where a patient does not show, is late, leaves early, or the interpreter no-shows, you need to generate a “Missed Appointment” letter under “Transcription and Compilation” since you will not have a written request.

If medical records are provided prior to the appointment, the examiner has 30 days to produce a record review report, in addition to the missed appointment fee. They will be reimbursed for the review of records in excess of 200 pages. It is required that the examiner include in the report a verification under penalty of perjury of the total number of pages of records s/he reviewed as part of the medical-legal evaluation and preparation of the report.

As a reminder, any pages reviewed for this record review report will be excluded from the page count for reimbursement when the face-to-face or supplemental evaluation takes place in the future.  

Checklist of Supporting Documentation

IBR examples of what NOT to do:

These IBR examples fail to adequately support that the appointment was canceled within 6 business days.

If you’ve got questions or concerns regarding the ML200 or any other forms, don’t hesitate to reach out to the Simplexam Team!

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