An attorney calls about a nursing home case. Two boxes of records, maybe more. "What would you charge to go through these and give me a timeline?"
You want to sound confident. You also have no idea whether to say a number per hour, per page, or per project.
Setting fees is one of the most common sticking points for new legal nurse consultants (LNCs). This article explains how LNC fees are usually structured and how to choose rates you can stand behind, without guessing.
LNC fees are different from expert witness fees
A nurse expert witness is paid for independent opinions and testimony. An LNC is usually paid for analysis and work product that stays inside the legal team: record review, chronologies, case screening and research.
Because the work is different, the fee schedule looks different too. Many nurses who do both keep two separate schedules.
The common pieces of an LNC fee schedule
Hourly record review
This is the backbone of most LNC fee schedules. It covers reading and analyzing medical records. State your billing increment (for example, tenths of an hour) so invoices are easy to follow.
Medical chronologies and summaries
Some LNCs bill chronologies hourly. Others offer a project estimate after a quick look at the volume of records. If you estimate, say what happens if the records turn out to be much larger than described.
Case screening or merit review
A focused early review to help the attorney decide whether to take a case. Some LNCs offer this as a flat-fee service with a clear scope, such as a short verbal or written summary.
Research
Time spent finding policies, clinical guidelines, drug information and nursing standards that applied at the time of care.
Written reports and work product
Summaries, deposition question outlines, and memos. Usually billed at your hourly rate.
Rush fees
If an attorney needs work faster than your normal turnaround, a rush rate or surcharge compensates you for rearranging your schedule. Define what "rush" means in days.
Retainers and minimums
A retainer up front, applied to your first hours, protects you from unpaid work. A minimum (for example, a set number of hours per case) covers the time it takes to open a file, communicate with the firm and get oriented.
Travel, mileage and expenses
If you visit a firm or attend a meeting, state how travel time and costs are billed.
Payment terms and cancellation
Invoice timing, payment due date, accepted methods, late fees if you use them, and what happens if a project is canceled midway.
How to choose your rates
You will see a wide range of LNC rates online. That is because fees vary a lot based on:
- Your clinical specialty. Some specialties are harder to find.
- Your experience as an LNC. New consultants often price differently from established ones.
- Certifications. Clinical and legal nurse consulting certifications can support a higher rate.
- Your region and the firms you serve.
- The type of work. Fast-turnaround or highly technical projects often cost more.
A simple process:
- Look at published LNC fee schedules and surveys. The American Association of Legal Nurse Consultants is a good place to start learning about the profession: aalnc.org.
- Pick a starting hourly rate that reflects your clinical value, not just your bedside hourly wage. You are running a business with your own taxes, insurance, software and unpaid admin time.
- Decide which services are hourly and which are flat. Flat fees work best when the scope is clearly defined.
- Set your terms (retainer, minimum, payment due date) before the first call.
- Review once a year. Raise rates as your experience and reputation grow.
Mistakes to avoid
- Quoting on the spot. It is fine to say, "Let me send you my fee schedule."
- Per-page pricing without limits. Records can be far larger than expected.
- No retainer. It is hard to collect after the work is delivered.
- Underpricing to win the first case. It is harder to raise a rate with a firm than to start at the right one.
- Any outcome-based fee. Your pay should never depend on the result.
Make it look professional
A clean, one-page fee schedule on letterhead that matches your CV signals that you are organized and easy to work with. Date every version and keep a copy of what each firm received.
Fee ranges vary widely by specialty, region and experience. This article does not recommend specific dollar amounts.