# Claim File Review Services for Adjusters — Medrecords AI > Upload the claim file. Get the cited summary, chronology, and flagged findings before your first read: every determination documented for the file. Canonical page: https://medrecords.ai/solutions/insurance/ --- [Home](https://medrecords.ai/) ›[Solutions](https://medrecords.ai/) ›Insurance & Claims Medical record review for claims ## Cut review time and leakage — with an audit trail. Medical record review for insurance and claims teams cuts review time and leakage while keeping an audit trail. Upload the claim file and get the cited summary, the chronology, and the flagged findings before your first read, with every determination documented for the file. [Book a demo](https://medrecords.ai/demo/) [Estimate Your ROI ](https://medrecords.ai/plans/self-service/) Claim #48-2214 · first read flags $473 flagged across 3 findings — all cited Duplicate CPT 99213 — billed twicep.312 · p.318 Treatment gap — 6 weeks, no documented carep.212 Prior injury undisclosed — 2019 lumbar strainp.31 Summary & chronology ready for determinationcited Every determination documented for the file The status quo Adjusters inherit claim files thousands of pages deep: records, bills, statements. Manual review drags out every determination, and it's *exactly where leakage slips through unnoticed.* 40+ open files on your desk Monday 3 new packets in the queue 1 reserve review due Friday ### 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 claims determinations. You shouldn't have to patch together PDFs, bill review spreadsheets, and adjuster notes to settle a claim. Medrecords gives you one structured, auditable view — ready for the determination. 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 → #### Triage the queue, not just the file Configurable workflows sort, route, and prioritize claims documents automatically, so every adjuster opens a file that's already organized, and the complex claims surface first. #### Standardize review across every desk The same structured, cited output on every claim — across adjusters, offices, and TPAs. Expert-verified before it reaches the desk, consistent enough to audit. Who this is for ### You have 40 open files. Reserves are due Friday. Adjusters live between the queue and the deadline. Medrecords does the first read on every file, triage takes minutes, the red flags come to you, and the determination is defensible on the first pass. Prior injuries and pre-existing conditions identified up front Initial file review cut from days to hours Cleaner pre-work that cuts downstream IME and legal spend Your queue · Friday 09:00 reserves due #48-2211 — Summary ready, all findings citeddone #48-2214 — 2 flags · unsupported charges $12,480review #48-2216 — Deduped 1,847 → 612 pages−67% #48-2219 — Gap in care flagged · 47 daysp.212 Triage done first thing — every flag sourced The objection ### "Will this hold up if the file gets audited or litigated?" Every finding is traceable to its page; every PHI access is logged. The audit trail isn't a feature bolted on for compliance — it's the product. Your file notes cite the same sources the auditor sees. 60% less first-read time in the pilot "The flags queue changed my mornings. I open files that are already triaged — and every flag has a page number I can put in my notes." Senior claims adjuster · regional carrier, Midwest Who we serve ### One platform. Built for everyone who works the file. The same defensible, cited record — shaped to how each team reads it: the case, the claim, or the exam. Roles [Medical EvaluatorsDefensible IME opinions, faster](https://medrecords.ai/solutions/medical-evaluators/) [Claims AdjustersTriage and settle sooner](https://medrecords.ai/solutions/insurance/) [Defense LawyersSurface the case-deciding fact](https://medrecords.ai/solutions/legal/) [Legal Nurse ConsultantsChronologies in a fraction of the time](https://medrecords.ai/solutions/legal-nurse-consultants/) Organizations [Insurance CarriersScale review across every claim](https://medrecords.ai/solutions/insurance-carriers/) [Law FirmsLitigation-ready case files](https://medrecords.ai/solutions/law-firms/) [TPAs & Case ManagementStandardize across clients](https://medrecords.ai/solutions/tpas/) [Government & Public SectorCompliant, auditable records](https://medrecords.ai/solutions/government/) Use Cases [Workers' CompensationTrack treatment and gaps](https://medrecords.ai/solutions/workers-comp/) [Medical MalpracticeReconstruct the timeline](https://medrecords.ai/solutions/medical-malpractice/) [Personal InjuryCited evidence on demand](https://medrecords.ai/solutions/personal-injury/) [Independent Medical ExamsStructured, exam-ready packets](https://medrecords.ai/solutions/ime/) [Not sure which fits? Talk to us about Enterprise ](https://medrecords.ai/demo/) ### Run one claim file through it. Pick your messiest open file. See what it flags, and what the flags cite. [Book a demo](https://medrecords.ai/demo/) [Test a file ](https://medrecords.ai/test-a-file/?src=solutions-insurance)