Independent Medical Evaluations (IMEs) Explained

FAQ	Answer
What is an Opioid Management IME?	An Opioid Management IME is an evaluation performed by a qualified medical professional to assess the need for continued opioid treatment and to determine if alternative pain management options should be explored.
What is a Headache and Migraine IME?	A Headache and Migraine IME is an evaluation conducted by a medical expert specializing in neurology or pain management to assess the severity, frequency, and impact of headaches and migraines on an individual’s life and to provide recommendations for appropriate treatment.
What conditions are typically assessed in an Opioid Management IME?	Conditions such as chronic pain, musculoskeletal disorders, cancer-related pain, and other conditions where opioid use may be considered as part of the treatment plan.
What conditions are typically assessed in a Headache and Migraine IME?	Conditions related to recurring headaches and migraines, including tension headaches, cluster headaches, and migraines with or without aura.
Who performs an Opioid Management IME?	An Opioid Management IME is conducted by a medical expert specializing in pain management or addiction medicine.
Who performs a Headache and Migraine IME?	A Headache and Migraine IME is usually conducted by a neurologist or pain management specialist with expertise in treating headache disorders.
What is the goal of an Opioid Management IME?	The goal of an Opioid Management IME is to assess the appropriateness of opioid treatment, evaluate its effectiveness, and determine if any adjustments or modifications are necessary.
What is the goal of a Headache and Migraine IME?	The goal of a Headache and Migraine IME is to evaluate the impact of the headaches or migraines on an individual’s daily life, identify triggers or underlying causes, and recommend treatment options to reduce the frequency and severity of episodes.
Are these evaluations covered by insurance?	In many cases, these evaluations are covered by insurance, but it is recommended to check with individual insurance providers for specific coverage details.
Is a referral from a healthcare provider required for an IME?	Typically, a referral from a healthcare provider is required for both Opioid Management IME and Headache and Migraine IME.