Standard of Care Cost and Fee Structure
The cost of a standard of care review is the physician's time, billed hourly across record review, analysis, the report and testimony. The record review dominates: a board-certified physician reads the whole record for the episode of care, with the imaging and clinical documentation, before forming an opinion, so record volume and the number of providers and questions under review set most of the hours. Counsel controls the scope, standard of care alone or causation with it, and the completeness of the record sent.
Typical range
Standard of care reviews are scoped to the clinical questions and the volume of records involved. KWVRS provides a written fee schedule and a cost estimate before work begins.
What drives cost
- Volume and complexity of the medical record
- Number of clinical questions and providers under review
- Whether the assignment includes causation in addition to standard of care
- Need for literature review to document accepted clinical standards
- Number of report revisions and rebuttal opinions requested
- Deposition and trial testimony, including preparation and travel time
Billing structure
Standard of care reviews are conducted by a board-certified physician and billed at an hourly rate for record review, analysis, report preparation, and testimony. A retainer is established at the outset and applied against time incurred. The current rate schedule and retainer terms are provided on request and confirmed in a written engagement agreement.
Questions about standard of care cost and fee structure
What drives the cost of a standard of care review?
The record, first: every page of the episode of care, the imaging and the clinical documentation is read by the reviewing physician, so volume and complexity set the base. The number of clinical questions and of providers whose care is under review comes next, then whether causation is included alongside standard of care, and whether a literature review is needed to document the accepted clinical standard for the questions asked.
How is a standard of care review billed, and what is the retainer applied against?
Hourly, for the physician's record review, analysis, report preparation and testimony; there is no interview or testing phase, because the opinion is a reading of the record. The retainer is drawn first against the record review, which sets most of the hours, and each scope added, causation or a literature review, is billed as further physician hours, for counsel presenting a claim and counsel defending one.
Does KWVRS provide a cost estimate before a standard of care review begins?
Yes, once intake has confirmed the specialty fit, so the estimate is for a review the physician will actually conduct. Send the complete record for the episode of care with imaging, the clinical questions and the providers under review, any opposing medical opinion already served, and the disclosure deadline; state the specialty of the care under review when you inquire.
Does deposition or trial testimony add to the cost of a standard of care review?
Yes, at the physician's rates for preparation and for the deposition or trial time, as the testimony cost page describes. The preparation is specific to a medical opinion: the physician re-reads the episode of care and the literature relied on, since cross-examination tests the standard applied and the timing of each finding against the record. Rebuttal opinions written as opposing medical reports are produced are billed as further hours.
Is a review of an opposing standard of care opinion priced separately?
Yes. A rebuttal opinion on a medical report the other side has served is scoped when that report is produced, because its size follows the report: the record it relied on, the standard it applied and the literature it cites are each checked against the file. It can be the whole engagement or an addition to a review already under way, and its hours are billed like any phase.
Does the board-certified physician change the cost of a standard of care review?
The review is the physician's work throughout, so the physician's hourly rate applies to the record review, the analysis and the report. The reviewer is a licensed physician, and the specialty of the care under review is matched at intake, before scope and retainer are set, so a matter outside that specialty is identified before any hours are billed.
Related reading
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