Seventy-two hours, on an expedited review.
External review record packets put the full clinical record in front of the reviewing physician indexed against the plan document, the applicable medical policy, and the evidence base. On a 72-hour expedited clock, the reviewer spends it on the determination rather than on assembling an eight-hundred-page file.
The rulebook is federal. The referee publishes the scores.
We do not build for a case type until we can name the standard that defines a correct output and the person who grades the file against it. External review has both, and the grader publishes overturn rates by reviewer organization.
That is what makes the packet the buildable half of the job: the determination is a clinical judgement, but the file behind it has a defined shape and an auditable trail.
One hundred to eight hundred pages, arriving out of order.
An external review case file runs 100 to 800 pages, with a midpoint around 450. It arrives as more than one production: the plan's claim and appeal file, the treating provider's chart, and whatever the enrollee submitted directly. The three overlap heavily and agree with each other imperfectly.
What makes those pages hard is not their number. It is faxed scans of faxed scans, handwriting in the margins of office notes, the same discharge summary appearing in three productions under three different Bates ranges, and the occasional page that belongs to another patient entirely.
That range is our own estimate of the annual external review volume across federal and state processes, not a published figure. We show the working rather than a false precision.
Fewer than 1% of denied ACA marketplace claims are appealed at all, so external review is a small, high-stakes slice of a very large denial population. Every file that reaches it is one somebody decided to fight for.
Four steps, starting with one real file.
Send one real file
A closed external review case, as it actually arrived: multiple productions, degraded faxes, the plan documents alongside the clinical record. In the demo case, 342 pages across 2 productions with a wrong-patient page quarantined before the read starts.
We return the read
A sorted, deduplicated packet with a chronology, the denial rationale and plan language located, and every line page-cited to its source. You compare it against what the reviewer on that case actually had to work from.
We scope the build
Your packet order, your section headings, your export format, and the intake rules that separate an expedited request from a standard one. If the case type is not buildable to your standard, we say so at this step rather than after.
You run it
Your intake team loads files, your reviewing physicians read the packet and make the determination. We never write the determination, never grade the appeal and never touch the clinical judgement.
The rules the platform never breaks.
EVERY LINE CITED
HIPAA, under a signed BAA
Every file is handled under our Business Associate Agreement, from the first byte.
Never trains a model
Your records are never used to train any AI model — ours or anyone else's.
Every line cited
If we can't cite it, we don't say it. Every sentence links to its source page.
Deleted after delivery
Files are deleted 30 days after delivery, with a full audit log of every access.
Four capabilities behind every review packet.
The external review packet is one deliverable of the same platform that reads, sorts, and cites the whole record.
Document Sorting & Packet Builder
Multiple productions sorted into one ordered packet, deduplicated across sources, in the section order your reviewers read in.
Medical Chronology
The treatment timeline behind the disputed service builds itself, synced to every source page across every production.
Literature & Standard-of-Care Matching
The published evidence base surfaced alongside the disputed service, so the reviewer weighs it rather than hunts for it.
Verifiable AI Citations
If we can't cite it, we don't say it. Every line in the packet links back to the page it came from, which is what an audited decision file needs.
External review record packets, answered.
Send one file. We'll tell you what we can read.
No obligation. If the case type is buildable we'll scope it; if it isn't, we'll say so.