Finding the Middle Ground

Dane Street’s niche in independent medical examinations and peer reviews is turning the midsize competitor into a market leader

Will Fulton has found success at Dane Street by surrounding himself with the very best. “You need to surround yourself with trustworthy people,” he says. “The team is paramount.”
Will Fulton has found success at Dane Street by surrounding himself with the very best. “You need to surround yourself with trustworthy people,” he says. “The team is paramount.”

When Will Fulton started Dane Street in 2008, he decided it needed to be a company that excelled at just one or two areas. A former executive at managed-care organization Concentra, Fulton believed in the value of companies focused on solving business needs in very specific markets. He started the company focused only on peer reviews: reviews of medical records by board-certified, specialty-matched physicians who provide independent, expert recommendations on how an insurance company should approach claim settlement.

In 2014 after nearly eighteen months of infrastructure planning and build out, Dane Street launched its second major product offering: independent medical examinations (IMEs), which offer onsite physical examination by Dane Street’s physician panel. These two complimentary products now offer clients the ability to choose from—or combine—peer reviews and IMEs, performed by Dane Street.

“Due to the breadth and expertise of our national panel of physician advisers, we can provide a credible and objective review of medical records and history to address critical questions around such areas as the medical appropriateness of specific procedures, causality and compensability related to episodes of care, and go-forward treatment plans around medication regimens,” Fulton says.

Prior to Dane Street’s emergence, there was just one large roll-up company, called Exam Works, and many small “mom-and-pop” companies specializing in peer reviews and IMEs. The independence and service model of large organizations were being questioned, while the smaller organizations lacked scale, capacity, and meaningful technology investment. “We saw this great opportunity in a $4 billion industry to provide strong national and regional services for insurance payers,” Fulton says. “Instead of being a company with ten to fifteen different products in this space, we could focus on being the best at just two.”

When Fulton started his company, he brought with him four executives from Concentra, and many of his nearly one hundred employees have come to the company through referrals. This hiring process ensures that the people who work at Dane Street are dedicated, thorough, and passionate about the work they do on behalf of their clients. “We encourage our staff to be open, honest, curious, self-critical, and respectful of each other,” Fulton says. “Each day, we try to live up to our company motto, which is, ‘We get the job done.’”

The culture at Dane Street reflects this motto—team members work hard and are committed to their responsibilities. The staff exudes enthusiasm, with a strong attention to detail and client-specific needs. While the tempo is fast-paced, the team nature of the job has built great rapport among the staff and has resulted in a very low employee turnover rate. “The biggest way to ensure work-life balance is to staff operations in a way where employees are able to take breaks and PTO as necessary,” Fulton says. “Nothing is more toxic to long-term growth and employee satisfaction than not being able to accommodate the work-life balance of our staff.”

Part of getting the job done for Fulton is the technology component of peer review and independent medical exams. Using Ruby on Rails, Dane Street developed a hub for claim initiation, messaging, self-service tracking, and outcome reporting. By investing in the core platform and user interface, Dane Street is able to reach clients in real time, so insurance companies can tell that a patient was examined and what the outcome was as soon as reasonably possible.

Dane Street has grown quickly over the last six years, moving from just five people at founding to more than one hundred employees and two service lines today. But Fulton wants to ensure his company’s growth is sustainable, and to be the best at that. “We commit ourselves to delivering concierge-level service to our IME and peer-review clients every day,” Fulton says. “We’re not going to branch into ten different products—we’re just going to continue to explore ways to deliver value and innovation in these two areas.”