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Medical Record Review for Insurance Companies

Medical Record Review for Insurance Companies

Insurance medical record review must be accurate and thorough because it is imperative to prove fairness, medical necessity, fraud, embellishment, and up-coding among other aspects. This is vital from the point of view of making a fair claim settlement in injury, medical malpractice and other medical litigation. Managed Outsource Solutions (MOS) offers a thorough and objective analysis of the relevant medical records that will help you objectively investigate an insurance claim. The information we provide will give you a better understanding of the various aspects of the claim and better equip you to negotiate and settle your insurance claims. Check out our free trial offer.

Benefit from 30 – 40% cost savings. Call 1-800-670-2809 to talk to one of our solutions managers.

Medical Review

Team Specialized in Assisting

Insurance Defense Attorneys

MOS has many years’ experience working with insurance adjusters and defense attorneys. Our medical review team that includes physicians and registered nurses has the knowledge and insight to analyze the records and find sources of information beyond diagnoses, test results, and prognoses that may prove important to the defense. We look for:

  • Prior patient problems, prior medications, and prior medical conditions that could prove to be a potential defense.
  • Contradictions if any, to determine if the details of events given to physicians are at odds with other evidence in your case. These can be used to impeach the witness because it raises questions regarding the credibility of the person testifying.
  • Missing information in the records that may prove valuable at some stage or other.

We review the entire medical documentation and prepare medical summaries that will show whether the diagnosis is accurate, and whether the treatment/care given is reasonable or necessary. With specialized expertise in reviewing medical records for insurance defense, and extensive knowledge in medical procedures and terminology, we can prepare an accurate chronology of medical records.

What Distinguishes MOS

  • Customized services catering to individual client requirements
  • Dedicated workforce
  • Stringent quality control measures
  • Daily (as appropriate), weekly and monthly status reports
  • Flexibility to work with any client centric software
  • Customizable TAT from 4hours, 6 hours, 8 hours, 12 hours or 24 hours
  • HIPAA compliance ensuring absolute confidentiality and security for all data entrusted with us

Get in touch with us to learn more about our medical record review services for insurance companies. Ask us for a free trial.

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