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Medical record review for TPAs

One standard of review — across every client program.

Hit every SLA, standardize quality across every desk and every client, and walk into renewals with the audit trail that proves it.

Program board · all clients SLA view
Acme Insurance — 14 files · 24h SLA6h avg
Beta Mutual — 9 files · 48h SLA11h avg
Gamma Fund — 22 files · 24h SLA8h avg
Client audit — Beta program, export assembled1 click
Per-file cost metered for bill-backby program
Renewal-proof: the SLA record, on the record
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.

every client
measures turnaround differently
all of them
measure it
1
audit finding can cost the program

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.31 p.212 p.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.

Intake · Case 2025-0412 reading — p. 1,462 / 1,847
PDF ED_records · 214 pp DOC ortho_chart · 1,128 pp JPG nurse_note · flagged
Multi-model read · dedupe · claimant split · index
1,847 pp in 612 unique 14 flagged 1 DICOM study
Organized recordby provider · date
01Jul 17Medical Records
02Jul 17Billing Statements
03Aug 06Physician Notes
612 pp indexed · every row citedopen the case →

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
The objection

"Can we white-label the output for our clients?"

Yes. Client-ready, branded deliverables per program — your logo, your format — with per-file cost metering for clean bill-back. Your clients see your standard; the platform stays invisible.

100% SLA compliance in the pilot quarter

"We put the audit trail in front of the client at renewal. That conversation used to be defensive — now it's the pitch."

VP Operations · national TPA

Benchmark one client program.

Run 30 files. Compare turnaround and findings against your current process.