321: What’s Hiding in Your Medical Records? The 5 Patterns That Matter with Ashley Davis

Melissa (: 00:00

Burnout to All Out. Fam, I am so excited for you all to get a chance to hear from the cream of the crop. These are our Burnout to All Out Elevate 360 mastermind clients who've been in my master, my high level mastermind all year this year. And we do a summit once a year with our mastermind clients to debut their zone of genius.

What is incredible is that these clients all embody a 360 degree approach to business. They all contribute in one way, or fashion as subject matter experts that contribute to the pillars of Elevate 360, which is truly that we believe that bodies build businesses and that we have to have business strategy and legacy strategy as well. And so what is really cool about these clients is that

through a series of a couple of days of a summit, they were able to highlight and bring value and educate in their fields, whether it was around self leadership, leadership in business, business strategies, energetics and mindset and or legacy and how we take what we're doing and make our money work harder than we did for it to create impact and legacy over time. And so they,

really embody all that represents the 360 degree approach to business and the burnout to all out through line of our mastermind. So over the next couple of episodes, you are gonna hear from all of these experts. You're gonna get the details to their work in the notes section. And hopefully you're inspired as well as to what is possible.

for you as an entrepreneur and scaling your businesses the way these incredible human beings have. So hope you enjoy the series. I am so excited for our next speaker this afternoon. And that is with Ms. Ashley Davis. Ashley, so excited to have you here. You know, we've gone Mac, we've started macro from like real estate investing.

Melissa (: 02:22

down into strategic systems that scale. We've been talking about leadership with Renee. Now what I love as we're kind of rounding out today is like getting into a specific founder who has pivoted out of the nursing realm and launched her own business in the medical case management space and legal nurse consulting, which is obviously super niche, right?

If you've been listening yesterday and today to me talking about messaging and being very, very specific and who you're working with, Ashley is very, very micro-specific in what she does in the legal nursing consulting space. And so I'm really excited to be featuring you today and really talking about your journey and your zone of genius when it comes to medical records. So let me start with this.

Ashley, I'm gonna start with your bio here. So Ashley transforms how attorneys approach medical evidence in personal injury and medical malpractice cases, leading 12 specialized nurses who go far beyond basic chronologies to uncover strategic medical insights that actually move cases forward.

Her investigative approach consistently reveals documentation discrepancies, audit trail irregularities and strategic vulnerabilities that others overlook. Insights that become foundation for stronger depositions, better settlement positioning and case changing discoveries. Attorneys consistently report that Ashley's analysis completely changes their case strategy.

leading to higher settlements for plaintiffs and stronger defense positions through her ability to review cases with completely fresh eyes and deliver strategic medical intelligence before opposing counsel finds critical weakness. Most attorneys know medical records matter, but few realize the strategic vulnerabilities hiding in plain sight. today,

Melissa (: 04:38

We'll talk with Ashley about the five critical patterns that can significantly impact case outcomes and patterns that even expert witnesses often miss. And you'll discover how to spot documentation, how to spot documentation discrepancies and strategic vulnerabilities before opposing counsel finds them and turn complex medical evidence into your competitive advantage. So

So such a really interesting in depth space that you are in Ashley that maybe some of our audience doesn't know a whole lot about. And what I thought we could do before we dive in is actually start with your journey. how, what brought you from nurse to entrepreneur? Like, can you talk to us before we really get into your zone of genius today?

Like how did you know or did you know, you know what, like in the throes of nursing, you were like, I wanna be an entrepreneur and I'm gonna get into like medical record analysis. This is my thing. Like talk to us a little bit about this pivot and jump into entrepreneurship now running a business with 12 specialized nurses who work under you.

Yeah, well thank you so much for that welcome, Melissa. Yeah, so I had been in OB nursing for about six years when I had my daughter.

And it's that kind of started a cascade of health problems for me. And I started to consider like, what does my future look like as a nurse? Cause I don't know if it's going to be at the bedside anymore. So I honestly kind of stumbled into legal nurse consulting, looking for other avenues. And it really just kind of opened my eyes that this was something I feel like I was meant like, this was a journey I was meant to go on. Like I, mean, through nursing school, like even at the bedside, getting to know my patients, I've always loved like digging it.

Ashley (: 06:33

into their records, because there's a lot you don't get at face value by just asking questions or maybe not asking the right questions that a little bit of an investigation can open the door to a lot more. So I always enjoyed that. And in nursing school, I took on a lot of leadership responsibilities. So I knew I was good at networking and working with people and managing people.

So once I kind of found legal nurse consulting in the depths that I did, it just made perfect sense that this was the direction that I wanted to go. There's a lot of like detective work in it. I joke now that like in another life, I should have been like in the CIA, cause I'm really good at finding information, especially the stuff that's not super obvious and kind of going down those rabbit holes that in this line of work often pay off. So.

That's awesome. Now this is just a random off the cuff question that I have, because I'm just really curious about how AI is impacting your business. Because I think about confidentiality of like cases and things that you're reviewing, but I'm curious, like with efficiency, like are you guys in your company leveraging AI to help catch some of these things or is it all like manual?

To a degree, like I am definitely leaning a lot more into it. Of course, we're working with patient health information, so it's all protected and we have to keep it very confidential, but I am using it to help in strategy. So one thing that sets my firm out from a lot of other legal nurse consultants is that we not only deliver the medical details, but we're connecting the dots and we're offering like the strategy and like what those details mean behind it.

So I've started to lean into AI a lot more to help me put some of those thoughts together and evaluate some different angles that I wouldn't have come up with on my own. So by a template that I use regularly, I can plug in a couple of the details and be like, what am I missing here? What have I not considered? Which can identify another line of investigation or a line of questioning or suggestions for our attorney clients on what they need to do next. So that way we can

Ashley (: 08:43

further establish our position.

Okay, awesome. Yeah, I was just curious because I know like in your field and in many fields There's like confidential stuff that you can't like upload, but then there's also such an opportunity there Okay. Well, let's talk about like the the five patterns that can undermine your case I know these were the things that you really wanted to talk about today. Like what's really hiding in medical records?

specifically for our attorneys out there. So can you speak to these five patterns? Like what are they and how are they undermining the case?

Yeah, absolutely. Well, I would say like these are probably the five most common patterns. There's a lot more layers to it. But one of the first ones that we look for is mechanism of injury. So does what they say happen to cause these injuries line up with what the evidence shows? You know, does their imaging support it? Are they consistent in in how they're reporting this throughout their visits or their inconsistencies in their stories? Sometimes and I have a lot of experience

working on both plaintiff and defense side. So when we evaluate a case, we're like looking at it from the big picture, 30,000 foot view, like both angles. How is each side gonna approach it? So taking that into account, know, like if there are inconsistencies, you know, if they originally report like on the scene that they never lost consciousness.

Ashley (: 10:11

they were fine, they didn't have any pain, and then they go to the doctor a couple of days later and say that they were passed out for five minutes and woke up and somebody's dragging them out of the car. And that's not what the EMS reports show. Then that creates some credibility issues. So really looking for those conflicting either mechanisms of injury or stories that went into play. Sometimes you'll see they'll say that they'd...

slipped on water. We do a lot of like restaurant like slip and fall stuff too. So they'll they slipped on water in a restaurant and then you know like several visits later they tripped on you know a bump in the floor. So like finding those irregularities that might not be super obvious but a lot of those subjective statements make a huge difference in determining credibility and causation which are huge for the success of a case.

Okay, so that's number one, right?

Yep. So number two is going to be conflicting injury descriptions or progression, which we kind of talked about already, but a lot of the time we're finding that people have, you know, comorbidities, meaning they have other, other like disease processes or other injuries or preexisting injuries that have happened. So if we're finding conflicting information, like sometimes people find it an opportune moment to bring up an old neck complaint that really has

no bearing on what the actual injury or mechanism like we talked about that they sustained, but they'll try and add it into their claim or group it in so that way they can get that extra medical care. So being kind of cognizant of that and what are the signs that that's taking place or what are the signs that their injuries that they're reported are definitely supported with the medical documentation. Number three is going to be high pain scores without clinical correlation.

Ashley (: 12:01

So we do see this a lot when people are going to repeated chiropractor visits or something and they're reporting nine, 10 out of 10 pain every single visit. And they're also being documented as in no acute distress. They're not showing any external signs other than what they're saying as being in this extreme, untolerable pain.

So we look for other ways where we can support that. Cause sometimes, you know, it is legitimate. People are used to having chronic pain and they learn how to either mask it or deal with it. But then there's also times where, you know, if they have full like functional capacity, their day to day life hasn't been interrupted and they're making jokes during an appointment, but still reporting 10 out of 10 pain, like that just doesn't add up. So looking for signs that that's taking place is another big one.

Number four is gonna be gaps in treatment or non-compliance. So say if they are prescribed a set of physical therapy appointments to go work on their shoulder injury, did they show up for those appointments? You know, if they were told to go three times a week and you only see for 12 weeks and you only see them go once a week and they stopped after seven visits, but they are still claiming that their injury is.

progressing, it's not getting better, but they didn't follow the treatment plan or they didn't show up for their visits. They, we've got tons of no shows and like late cancellations. All of that factors into like how committed were they to their recovery and how big of a role did that play in their overall recovery process, which equates to the damages for a claim. And that's really where the money comes in. The last one that I pointed out is going to be preexisting conditions without clear aggravation. So I kind of touched on this earlier, but if they have,

prior conditions, like say they have a history of a prior knee replacement and they've had to go in and get repeated injections for this knee because it continues to cause them pain after this knee replacement, but then they take a fall. And then we have to look at, know, like how the previous medical records compared to the new medical records and if there's actually a change, you know, did they require more interventions? You know, did they have to go complete another round of physical therapy?

Ashley (: 14:16

subjectively and functionally, like how has their life been impacted? So that's what we're looking for to really kind of find the holes in a case so that way we can either prepare our client in how to rebut against it or support the claim or attack it if we're on the defense. So that way we can help them find those holes so that way they can minimize the damages because it may not all be truly related to the actual injury.

Awesome. You're just, you are such an expert in your field. Like just listening to you. Like I know that if I was an attorney, I would hire you in a heartbeat. So question for you. So this kind of like, obviously like you guys are expert in your field. I'd love to get into a couple of entrepreneurial questions around this because I also know working with you one-on-one, like you're working with multiple nurses. You're working, I mean, you've got a team of contractors, like 12. How many of you in the chat?

e working with people who are: 1099

with and working with numerous contractors, what do you think has made you so successful and having kind of a great lineup of contractors that work with you to deliver your services?

I feel like I have such a strong passion and this comes as both like a positive and sometimes that you know to my own demise of You know a striving for that perfection which you know to some degree it is absolutely necessary in my line of work because we can't have errors in our reports we cannot you know miss details because that can cost money that can cost our clients money and that can lose their trust so being super dedicated to you know producing a super high quality product

Ashley (: 16:26

has allowed me to develop really good relationships with my contractors because then they're learning from, you know, the mentorship that I'm able to provide and they're contractors. So they have their own businesses. They might be working with other hiring legal nurse consultants. So overall they're getting the benefit out of working with me because I'm helping to elevate them as well.

So I have several team members that are, you know, really dedicated and prioritize working on my cases. Cause I feel like we're always learning together and we're always able to elevate that product. So they, they end up walking away with something as well. They have something to show for, you know, the work that they've done. And, you know, it's kind of like spurred me into taking on more of a mentorship role as well. And I've identified this gap in the industry where people are having a really hard time producing these high quality products.

And I think overall we're doing the industry a disadvantage, know, our attorney clients, because we can reproduce and regurgitate the information, but if we're not connecting the dots for them and we're not showing them like why it matters, like why they need to know this, if it's not obvious, then we're missing the mark on helping them to, you know, elevate their damages claims and being able to support and advocate for their clients to the best of their ability. So by helping to mentor and raise nurses up to be able to come to this,

What I've now deemed as my standard, it's helping to increase the industry as a whole and make them better legal nurse consultants and more like critical thinkers in the strategy space.

So good. Another question for you, Ashley, and this is kind of selfishly for everyone to kind of hear, because I know we have a lineup of healthcare providers tomorrow too, that are going to be speaking. And I can say this from my own experience having a doctorate in pharmacy, that we tend to be risk adverse, because in the worlds we came from, when you make a mistake, people die.

Melissa (: 18:20

Right. And so, but you've made the leap, you've made the leap into entrepreneurship, which means you've taken calculated risks. Right. And, know, it's not necessarily innate in a lot of healthcare providers who have been conditioned to, I don't want to say not take risk, but to, not be risky, you know, to be a hundred percent confident. Right. And like the next step, right. And

So you're really inspiring, I think, to a lot of healthcare providers that you've been able to take the risk and you're like living the American dream. Do you have any advice to other healthcare providers who are maybe straddling a nine to five, a W-2, like thinking about launching a business, knowing, you know, seeing your success record and what you're doing and what you're running and what you're scaling. What do you have to say to the risk adverse healthcare provider who

dreams of launching a business one day, but has never been conditioned to take a calculated risk and move forward. Do you have anything to say to those people?

I mean, I feel like a lot of us are type A, especially, know, like nurses, especially like specific specialties, but you know, like having that, you know, foundation of a plan in place that, you know, where you can build, you know, the idea of what you want, you know, kind of like having that, that build, grow, scale background that

that background where you're, you you want to build this dream. So you like set out a plan and then you're going to grow it and go from there. But it all starts from the beginning. You have to take those initial foundational steps and build it. So I've actually

Ashley (: 20:03

I tried to do this in my own home with my husband who has been out of work and he's considered, you know, he's not in the healthcare space, but still somewhat risk averse. He's used to having like processes and manuals to follow. But I've kind of turned it into just that being able to be like, all right, well, this is the process you can follow your step A, B and C, you know, like, let's come up with a plan. Let's see what you want. Who's your ideal client, like all those kind of foundational things that are laid out in the beginning steps of starting a business and just getting started.

Like it's, you can, at the end of the day, you can also plan as much as you want and plan and plan, but unless you start taking action, it's not gonna come to fruition. So putting yourself out there and just taking some of those baby steps, even if it is just one step at a time, you're only spending five, 10 minutes here and there. That's still five, 10 minutes closer to your end goal than you were before. And that all adds up. So just basically, you know, like, yes, get a plan in place, but then get started and get moving and start checking off some of those steps.

Yes, I love all of that advice. It's like take, know, if you need a plan, like everybody needs a plan, like build the plan, but then just start taking, taking the steps, right? Okay. So I love this. I just love everything that you've had to share. Your journey is so inspiring. I know to so many, when it comes to elevate 360 and how you've embodied the 360 degree approach.

What do you want to share that you've been able to approach when it comes to life and business this past year?

Yeah, well, I feel like the and I knew going into it that the mindset was going to be huge for me. I knew that's what I wanted what I needed. But like all the work in modern entrepreneur with already having the backbone of like the BGS program in place. Also, I feel like has just given me so much more confidence and like direction as a person and an entrepreneur.

Ashley (: 21:53

Like I was able to better understand myself with all the work that we did with like the Enneagram and the self-reflection in the sound baths and the hypno breath work, like just getting a better idea of who I am, what I want and finding more of that authentic self in combination with the actual tactical steps to build my business. I feel like I'm just on such more confident trajectory and I know exactly where I'm going and I know the next steps.

Instead of, feel like previously I was kind of scattered. I knew I needed to do all these things, but there wasn't like a system in place that I knew that I needed to follow. It's allowed me to be a lot more organized and intentional with my next steps.

So good, so good. Well Ashley, this has been such an inspiration. Do you have a resource or tool to share with us today? Do you have anything that you wanna share and how do you prefer people connect with you?

Yeah, absolutely. So I am on LinkedIn. You can definitely find me over there. My business is Illuminate Legal Nurse Consulting. I do have a freebie. So I do have a document, the top five medical record red flags that we went over today. So you can actually go to

redflags.illuminatelnc.com and that'll take you straight to an informational page with the document where you can and feel free to reach out to me on LinkedIn.

Melissa (: 23:22

Awesome. This has been so insightful and I know that you've been such an inspiration to everybody. Again, thank you so much for showing up and sharing your goodness. I hope you found this episode as inspirational and kick ass as I enjoyed interviewing with it. If you love this and you resonated with it, please reach out, reach out to the speakers. Their information is in the notes.

feel free to reach out to us. And as always, if you're curious about mentorship and support and business coaching under the Burnout to All Out umbrella, go to burnouttoallout.co and check out what we have going on in the business mentorship world today, including business coaching and retreats that are live and experiential and take a 360 degree approach to business.

We can't wait to see you on the other side wherever we collide.