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Medical record review for TPAs

One standard of review — across every client program.

Medrecords standardizes claim file review across clients, adjusters, and jurisdictions — cited, audit-ready output that holds your SLAs.

Flags Summary Timeline Audit Acme · #48-2211 · 1,847 pp
Findings flagged for review
Gap in care — 47 daysp.212
Unsupported charge — CPT 99214 billed twicep.640
Inconsistent injury history across providersp.88 · p.412
Prior injury disclosed — 2019 lumbar strainp.31
Every access logged · PHI audit trail

Charges flagged

$0
across 3 findings · all cited
Source · p.640100%

The status quo

TPAs run client programs with different rules, formats, and SLAs. Manual review makes every file bespoke — slow to turn, hard to standardize, and harder to defend at audit.

0
pages in a complex claim file
0 hrs
of review per file, against the SLA
0 charge
missed becomes leakage that pays out

Get the defensible claim file — without assembling it yourself.

Everything a determination needs — structured, surfaced, and sourced. Medrecords organizes the file, flags what inflates the claim, and builds summaries backed by citations, so adjusters decide instead of dig.

Claim summary · auto-drafted

p.31p.212p.640

Summaries: the whole claim in one view

A complete, structured summary per claim — mechanism of injury, treatment to date, and disputed charges — every finding traced back to the page it came from.

Chronology · by date

Feb 11Date of injury — incident report
Apr 02Progress Note
May 22Gap in care · 47 days, no treatment
Jun 01Billing statement — CPT 99214
Jul 17Consultation Report

Automated chronology: the claim in order

Every page placed by date, provider, and event — with treatment gaps and billing anomalies flagged inline. Scroll the claim instead of hunting through PDFs.

Duplicate sets · 4Match similarity
Billing StatementmultipleReview
Consultation Report84%Review
Wrong claimant — J. Roeco-mingledSeparate
Remove all duplicates

Indexing & dedup: a clean, searchable file

Medrecords removes duplicate pages, flags mismatches, and separates co-mingled claimants — so the file behind the determination is one you can trust.

PHI audit trail · liveClaim #48-2211
09:14 · A. Rivera viewed p.212
09:16 · A. Rivera exported claim summary
09:31 · Dr. Chen reviewed flagged charges
09:47 · QA verified diagnosis fields
10:02 · Determination note added to file

Audit trail: defensible by design

Every access logged, case-level minimal access enforced, and every finding cited to its source — a file that stands up to audit, dispute, and regulator alike.

Adapts to each claim

Built for third-party administration.

Your product is consistent, defensible service. Medrecords makes every file meet the same standard — whatever the client, line, or desk.

01Jul 17Medical Records
02Jul 17Billing Statements
03Aug 06Physician Notes
PDF DOC JPG

Hit SLAs on every file

Files arrive organized, deduped, and summarized in hours — so turnaround commitments hold even when referral volume spikes.

Client-ready, audit-ready output

The same structured, cited deliverable across every program — easy to report on, easy to audit, and easy to show in the next RFP.

Who this is for

Every client measures your turnaround differently. All of them measure it.

TPAs win on consistent service. Medrecords makes every file — any client, any line — arrive organized, summarized, and cited, so SLAs hold and audits read clean.

Files organized and summarized within hours of referral
The same cited standard across every client program
Audit-ready output you can show in the next RFP
Client programs · today all on SLA
Acme Insurance — 14 files · 24h SLAon track
Beta Mutual — 9 files · 48h SLAon track
Gamma Fund — client audit requestexport ready
New program onboarded — same standardday one
Every client, the same defensible deliverable

Standardize across clients. Win the next renewal.

Structured, expert-verified claim files with the consistency and audit trail your client programs demand.