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Medical record review for self-insured programs

You kept the risk. Keep the margin too.

Self-insured programs run claims like a business, not a pool. Medrecords turns the file around fast enough to hit stop-loss reporting deadlines, cited well enough to defend at renewal — with a team no bigger than it needs to be.

Claim #SI-2091 · reserve review stop-loss ready
Claim opened — SIR tracking startslogged
Claim summary cited · 9 sourcesper finding
Incurred crosses $250k SIR lineflagged
Excess carrier packet assembledsame day
Audit trail complete end to endcomplete
When the excess carrier or the auditor asks, the file answers
The status quo

Self-insured programs carry the risk directly — no carrier spreads the cost of a slow review or a missed reserve. Manual review stays expensive precisely where the margin is thinnest, and every dollar of leakage comes straight off your own book.

no risk pool
to spread a slow review across
the SIR line
cross it and the excess carrier wants the file
1
reviewer, often doing a claims floor's job

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 #SI-2091
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 the risk you carry yourself.

When you retain the risk, review has to earn its keep. Medrecords gives a lean team the same structured, cited file a full claims floor would produce.

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 →

Catch the SIR line before it catches you

Files organized and summarized fast enough to flag a claim crossing into excess before the reporting deadline does.

One standard, any headcount

The same structured, cited file whether the team is one adjuster or ten — so self-administered claims hold up at renewal, at audit, and at the board.

Who this is for

The risk sits on your balance sheet. The busywork doesn't have to.

Self-insured employers and funds run claims like an internal department — lean, accountable, and directly exposed to every dollar of leakage. Medrecords gives that team a defensible, cited file without the headcount of a full carrier claims floor.

Reserve and SIR tracking backed by a cited file, not a hunch
Excess and stop-loss reporting packets assembled same day
One defensible standard, whether the team is 1 person or 10
Program status · self-administered on reserve
Findings cited — 9 sources attachedper finding
Reserve reviewed against the file, not a hunchverified
SIR threshold tracked automaticallyflagged $250k
Excess carrier packet — assembled in minutesready
Ready for the excess carrier, the auditor, or the board
The objection

"Will this hold up when our excess carrier — or our regulator — comes asking?"

Deployment options, PHI audit logging, retention controls, and BAA/DPA availability — stated plainly on a page your risk manager or broker can bookmark and forward. Diligence first; the demo can wait for the paperwork.

Request the security package

Benchmark one reserve file.

Run 30 claims. Compare turnaround and findings against what your team spends today.