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Consulting Services
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The NASI provides a number of healthcare services including treatment and consulting services to those injured in motor vehicle accidents.
NASI Consulting:
The North American Spine Institute’s healthcare team of professionals provides opinions regarding impairment, disability, and treatment plan appropriateness for individuals involved in motor vehicle accidents. Our whiplash assessment service includes development of treatment plans, file review, in person assessment, and consultation.
Our company is comprised of healthcare specialties in the fields of Chiropractic, Physiotherapy, Kinesiology, Psychology, Orthopedics, Neurology, Physiatry, and Internal Medicine.
Our service is unique in that our healthcare providers have injury specific post graduate training in the fields of whiplash, chronic pain and rehabilitation. This allows our providers to utilize the most up-to-date scientific research along with clinical examination and subjective findings to make the most accurate diagnosis and decision of appropriateness of care.
The North American Spine Institute is able to co-ordinate Independent Medical Assessments and Functional Ability Evaluations throughout North America within 24 hours of receiving a referral. Our credentialed specialists will ensure that the final report provides you with all of the answers that you require in determining the appropriateness of care.
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Our Services:
Expert opinions-determination on the reasonableness of:
- Chiropractic Assessments/Treatments
- Physiotherapy/Physical Therapy Assessments/Treatments
- Medical Assessments/Special Tests/Treatments
- Assisted devices
- Aqua therapy
- Sleep studies
- TMJ assessment
- Optometric assessments
- Psychological assessments
- Orthopedic assessments
- Neurological assessments
- In Home assessments
- Physical demand analysis assessments
- Work site assessments
- Rheumatology assessments
- Chronic pain assessments
- Multidisciplinary assessments
- Disability Management Pre and Post 104 weeks.
- Ergonomic Assessments
- Traumatic Brain Injury Assessments
- Motor Vehicle Crash Forensics Assessments
- Crash Forensics Reconstruction Analysis/Assessments (Doctor and Engineer)
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Expert opinions for court, deposition, and arbitration proceedings
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Legal Consultation Services: Advice for legal representatives regarding the clinical status and management of the insured.
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Treatment Plans:
The North American Spine Institute’s doctors have specialized training in whiplash, including whiplash biomechanics, occupant kinematics, and crash forensic training. This education and experience provides us with the unique ability to determine the exact/most likely structures injured relative to your specific injury. By using crash factors in conjunction with physical exam findings and subjective complaints, we are able to develop a customized treatment plan that concentrates on the primary soft tissue damage that you experienced and treat it appropriately and efficiently.
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Client Assessment:
The North American Spine Institute provides various injury review services for patients, lawyers, and healthcare providers in the United States and Canada. Our services include:
- Expert opinions for court, deposition, and arbitration proceedings
- Expert opinions in determination if an insured person has an impairment in which an OCF 18 or Pre-Approved Framework Guideline is more appropriate.
- Expert opinion in the reasonableness and appropriateness of Application for Approval of an OCF 22 Assessment or Examination.
- Expert opinion in the reasonableness and appropriateness of an OCF 3 Disability Certificate submission.
- Independent Medical Examinations (IME) / In Person Assessment: to determine injury extent and reasonable and appropriateness of prior or continued care.
- Legal Consultation Services: Advice for legal representatives regarding the clinical status and management of their client.
- Chiropractic Peer Consultation Services: We offer consultation services to assist in the management of your patients, particularly in situations of complex whiplash injury or poor therapeutic outcome from treatment. Our consultation services include patient review (file or in person exam) with treatment recommendations. We also offer a patient review (file or in person exam) for the purpose of writing a report to provide insight into treatment and management options that can assist you in attaining successful treatment outcomes for your patients.
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Insurance Assessments:
The North American Spine Institute provides various injury review services for insurance companies in the United States and Canada. Our reports provide objective and unbiased recommendation using our extensive clinical and academic training, review of records, claimant assessment (in some cases), and knowledge of current up-to-date scientific peer reviewed literature correlating to the case. Are recommendations can then be used to make informed decisions regarding the entitlement to medical and rehabilitative treatment benefits and/or disability benefits. Our services include:
- Reasonableness and appropriateness of a Treatment Plan submission (type and duration of care suggested), OCF 23 or OCF 18
- Reasonableness and appropriateness of an OCF 3 Disability Certificate submission.
- Reasonableness and appropriateness of an Application for Approval of an OCF 22 Assessment or Examination.
- Insurer’ Examination: (Paper Review or In Home Assessment) to assist the insurance company in the validity of claims, the appropriateness of continued benefits, and the appropriateness of past benefits received.
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IME:
Independent Medical Examinations
An independent medical evaluation (IME) provides a thoroughly objective, impartial assessment of the claimant’s diagnosis and prognosis for recovery including appropriateness of current treatment. Based on a comprehensive review of the claimant’s history, an extensive interview process and an objective medical assessment including crash forensics, occupant kinematics, and body biomechanics, the examining specialist issues a detailed, highly defensible report.
The North American Spine Institute provides honest and unbiased independent medical evaluations (including insurer and private examinations). We understand the complexities and issues involved including current guidelines and apply the same rigorous quality control process to each referral. Through our team’s dedication to professionalism and consistency, we have established a reputation of providing objective, defensible reports in a time-sensitive and customer-focused manner which has become our trademark.
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Functional Abilities:
Functional Abilities Evaluation
A functional abilities evaluation (FAE) objectively determines the claimant’s functional abilities and restrictions including a person’s strength, dexterity, endurance and overall functional abilities. By comparing FAE results to job requirements, the evaluation helps to facilitate a safe and timely return to the workplace. It can also help insurers to determine the extent to which physical impairments are present.
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Multidisciplinary :
Multidisciplinary Evaluation
This service combines the expertise of a number of specialists in a variety of medical disciplines to generate a thorough independent assessment that by considering all aspects of injury including the mental, physical and emotional harm.
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Pain Management :
Pain Management Evaluation
This is a multidisciplinary evaluation/program aimed to assist those injured in motor vehicle accidents who continue to experience pain and dysfunction post therapeutic intervention. The goal is to help improve both physical and psychological pain through evaluation and recommendation referrals to appropriate sub specialties. This evaluation helps to ensure a functional recovery and return to general and routine ADL’s as quickly as possible post MVA.
A pain evaluation consists of an examination to determine the amount of pain resulting from a motor vehicle accident and interfering with an individual’s normal activities of daily living. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage." Pain is subjective in nature and is defined by the person experiencing it, and the medical community's understanding of pain now includes the impact that the mind has in processing and interpreting pain signals as only 10% of our pain is actually perceived in the cortex (brain). This examination will consist of a physical examination, orthopaedic/neurological testing/evaluation, and outcome assessment review to determine injuries sustained and make recommendations for recovery. This evaluation can be preformed though a multidisciplinary group of pain management professionals or by a single pain management professional.
By performing this assessment in a timely manner, specific biomechanical positions and postures that are commonly used in general ADL’s which can cause an irreversible cascade of negative events that can lead to debilitating pain and overall dysfunction and possible chronicity of symptoms due to injury can be limited and/or avoided.
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Physical Demands :
Physical Demands Analyses
Physical demands analysis (PDA) is conducted to assess the essential duties/tasks and corresponding physical demands of an individual's occupation/job. The analysis/evaluation includes an interview with those involved with the person’s case including management and co-workers as well as an examination of the client’s overall functional ability in regards to specific work tasks. Based on an analysis of postural dynamics, physical exertion, body movement, repetition and strength required, among others factors such as body mechanics and posture, a comprehensive report is produced.
This report details the physical demands of the client’s job position, in addition to identifying any potential hazards/harms which are determined based on our evaluation and knowledge of the accident and injuries sustained that could cause further delay in recover or re-exacerbation of symptomatology.
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Disability:
Disability Management Consulting
We provide consulting to employers regarding a person’s ability to complete specific tasks including a comprehensive review of job tasks as compared to current disabilities and injuries and then help to implement a return to work plan with progress re-entry into normal work and general ADL’s with the hope to limit re-exacerbations of complaints and/or re-injury post resumption of general and normal work/life ADL’s.
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Ergonomic:
Ergonomic Assessment
Ergonomics is the science of equipment design that seeks to maximize productivity while coincidingly reducing the risk of injury or exacerbation of injury by adapting the work environment to meet the physical needs of the worker.
An ergonomic assessment is an evaluation of the biomechanics involved to complete tasks in the work environment that includes recommendations for engineering and/or administrative modifications to the workplace. Ergonomically designed workplaces can help employees avoid pain and injuries that may arise from repetitive tasks and prolong postures.
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Crash Examinations:
Motor Vehicle Crash-Forensics Risk Analysis Examination:
Crash Forensics Reconstruction Analysis, is a process commonly applied to motor-vehicle collisions and determines impact circumstances from physical evidence and reported testimony. This is accomplished thought the application of applied physics, research and medicine in determining potential injury outcomes of occupants. It is most dependent on the physical equations developed by Sir Isaac Newton, most commonly referred to as Newtonian Physics for the purposes of analysis in determining occupant kinematics and injury outcomes.
A crash analysis and functional medicine examination is essentially the application of physics to a collision scenario in order to determine force vectors and occupant reactions that help to determine the exact soft tissue injured and provide with reasonable certainty the extent of the injury sustained. This is accomplished by using physics and occupant kinematics / biomechanics along with current knowledge of forces affecting spinal motion and patient risk factors to determine occupant body actions during the accident sequence allowing for a precise and accurate injury explanation. Information such as the point of impact, the impact angles, safety factors (airbags / seatbelts), occupant position, and the weights of the vehicles are all inputs to the equations used in crash analysis of an accident. By performing this examination, a more detailed and specific treatment plan can be made which can help reduce the chance of chronicity of symptoms and help expedite the overall recovery process.
Our service is unique in that we have mechanical engineers who are able to reconstruct and accident scene using software to depict the accident and forces produced through the client’s spinal junction area’s and then Dr. Mazzarella, 1 of only a few doctors in the world with crash forensics specific training, can use this force information along with occupant kinematics, crash forensics, risk factors and client presentation to evaluate and determine the probability and extent of injury.
Further information and live full scale human volunteer crash testing video is available. Please contact the NASI for additional details.
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Traumatic Brain Injury:
Traumatic Brain Injury:
This examination will focus of the functions of these structures and the use of orthopedic/neurological testing and outcome assessments along with patient history to determine if a closed head injury/mild traumatic brain injury has occurred, and if so provide recommendations for treatment options to help limit the negative cascade of events that can occur post closed head injury/mild traumatic brain injury.
Our assessment will include an interview with the client covering such topics as any relevant history, accident details, current/past medical conditions, rehabilitation efforts, stress and mental dysfunction. The assessment will also include performing neurological and orthopedic testing on the brain stem, cranial nerves, dorsal columns, and brain lobes.
Traumatic Brain Injury Questionnaire – Pre Screen
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Medical IME:
Chiropractic/Physiotherapy/Medical IME:
Many insurance companies and private facilities have come under fire in recent years for hiring IME doctors without injury specific post graduate training to conduct their IME’s in regards to the necessity and appropriateness of benefits for those injured. As all most all motor vehicle accident clients are diagnosed with a WAD injury, whiplash specific post graduate training is an important variable when deciding on who should perform your company’s chiropractic IME.
The doctors at the NASI have a wealth of post graduate whiplash training and post graduate whiplash teaching experience which will help to ensure accurate, reliable and defensible reports while at the same time help to reduce secondary law suit claims for bad faith and a variety of other claims.
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In Home Assessment:
In Home Assessment:
An in-home assessment utilizes scientific principles and measures as well as subjective observations and evaluation to analyze the components of a specific home environment relevant to a particular client and their injuries sustained in order to make recommendations on need for assistance and assisted devices to help improve and expedite overall recovery. The assessment is frequently performed as part of a treatment plan for an injured client to gather data on the physical requirements of a home task for comparison with a client’s functional abilities. This data is also used to identify tasks, environments and equipment that present barriers to a client’s return to normal activities or which could exacerbate their current condition and delay overall recovery. The results are then used to aid in the restoration and accommodations of essential activities of daily living and provide a benchmark for rehabilitative functional goals with therapy.
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NASI Advantage:
Specialists Consulting
Consultations with a qualified specialist (in the specific field of injury: whiplash, pain management, rehabilitation) can be provided to ensure the efficacy of the claimant’s treatment plan. This service is of particular value when the treatment is in question and access to specialists is limited. Specialist consultations can be an effective and efficient case management tool when confronted by denials from insurers or plateaus of client improvements.
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Right Choice:
The Right Evaluator for Your Case
All referrals are reviewed by a Doctor with specialized injury specific training to your case, who will then determine the most appropriate course of action in regards to evaluation specialties. This helps to ensures that the most qualified, educated, and appropriate evaluators are matched for your file or in person review.
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On Time:
On Time All the Time:
Our providers are required to provide up-dates on the status of all referrals sent to them. These internal auditing processes allow us to meet the most stringent of timeframes.
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Defensible:
Accurate & Defensible
The accuracy of our reports combined with the injury specific training of our internal list of providers is what ensures a high quality, highly defensible and accurate report.
Our quality assurance program involves internal file audits and ensures that all assessors have specific post graduate training and are prepared for dispute-resolution proceedings.
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Providers:
NASI Healthcare Providers
Chiropractors Healthcare Provider List
Physiotherapists
Psychologists
Occupational Therapists
Kinesiologist
Massage Therapists
Neurologists
Orthopedic Surgeons
General Practitioners – M.D.
Acupuncturists Physiatrists
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