Reviewing requested medical and billing records

Reviewing Medical records does not have to be hairy jobReviewing requested medical and billing records

A few weeks ago, I posted a blog entry with tips on how to request medical records; but that is only half of what your paralegal should know. Knowing the basics on how to review requested medical records is the second part of making the actual request. After you have received the records—you should have an internal protocol on how the requested records are to be reviewed. Your paralegal should be able to review the requested records and do two things that will make your life easier for motions, discovery, and any other pretrial activities that may take place prior to the actual trial.

First phase of reviewing requested medical and billing records

The first phase of reviewing requested medical and billing records include starting a spreadsheet for the medical expense summaries. Our office contains a standard excel spreadsheet; which is set up to automatically run an ongoing total of the expenses as they are logged in the spreadsheet.

Second phase of reviewing requested medical and billing records
The second phase of reviewing requested medical and billing records is to verify that we have received all the billing and medical records, which pertains to a particular request or provider. Typically, as the records arrive we review them and also cross reference them with our components of the medical records checklist. If our review proves that we have not received all the basic medical records, then we are to call the provider to verbally verify there are no remaining records in their file. It is worth noting here that the standard lists of medical records components are just a guide we use for quality assurance. Not all providers have the same components; this shows us if there are any missing records.

Third phase of our reviewing requested medical and billing records

The third phase of our reviewing requested medical and billing records is the most fun for our office. Therefore, we suggest to all paralegals and attorneys to make a habit of doing this as the medical records come in. We prepare easy-to-read summaries of all the medical records. These summaries enable our attorneys to have one master document that informs them roughly of what all the records contain. During the summary process we flag things for the attorney to pay close attention to. In addition, the summary review can be used for the attorney to give to his or her RN investigator. While our office is not an RN investigator—we were taught in our early years by RN investigators how to write the summary reviews.

 Final phase reviewing requested medical and billing records

The final phase in our reviewing requested medical and billing records is making time lines of the events for the attorneys and investigators to use as a quick reference tool and/or to give us a starting point for our trial notebook and strategy books.
Our office procedure is to cross reference and prepare summaries as they become available. This practice allows ease in preparing demand letters and medical expense summaries (MES). We have found this lessens the load of our attorneys, allowing them to review our notes and review summaries first to find particular key points during phone calls and meetings with opposing counsels and clients.

While this not the entire process of reviewing requested medical and billing records, but it gives you a good idea what our office will do for your office and/or what you should train your paralegals to do.

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Holly Sheriff

A Self-Employed Virtual Paralegal, Business Coach, Public Speaker who just so happens to have CP! Dream Big-Believe and Do™ This blog and its writer are not held liable for any content that is republished or used by others. This blog has been edited by Jennifer Dudenhoeffer. Any personal information is made private and cannot be shared by third parties. . This blog is not intended to be legal advice. Further, this blog is the personal opinions of the writer and is not intended to be a legal analysis of any legal topic and should not be used as a substitution of an attorney or legal advice. If you have come to this blog with a specific legal issue or problem, you should seek the advice of a licensed attorney of your own choosing.