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MEDICAL STOP-LOSS SHOCK CLAIM REVIEW

The disclosure names the claimant. The record says where it's going.

Medical stop-loss shock claim review services read the disclosed large-claimant records behind a renewal: the diagnosis, the treatment regimen actually documented, the trajectory over time, and any transplant or high-cost therapy candidacy. Every finding is page-cited, and the underwriting decision stays with the underwriter.

Click any row → the source page it cites
Claim read · Case #IME-4812 documented
Adams, Timothy · large-claimant disclosure
342 pp / 2 packets received logged
11 duplicate pages removed free
p.140 — wrong patient quarantined
Pages 342 Documents 27 Cited 100%

The disclosure standard is published. So is the underwriter who prices it.

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. In stop-loss underwriting, both are already published.

The standard and the referee
The rulebook
  • The carrier's own disclosure form and underwriting manual, which define what must be disclosed and how a large claimant is evaluated
  • The plan document and the stop-loss policy's own terms, including the laser provisions and the run-in and run-out definitions
  • The clinical treatment guidelines relevant to the disclosed condition, which describe the expected regimen and its documented cost drivers
  • The no-new-lasers and rate-cap terms negotiated at the prior renewal
The referee
  • The stop-loss underwriter, who prices the layer and sets any laser
  • The reinsurer behind the carrier, which tests the underwriting file on a large loss
  • The plan sponsor and its broker, who accept or shop the renewal
An underwriter reading thousands of pages of disclosure records against a quote deadline Flat 10¢/page here, duplicates free
Claim read · Case #IME-4812 cited 100%
Packet342 pp / 2 packets · 11 deduplicatedlogged
Diagnosis & stagingAs documented, with datescited
Treatment regimenActual therapy, dose and intervalcited
Transplant candidacyDocumented evaluation statusflagged
Read delivered · cited 100% · no underwriting decision
How it works

3 steps between the disclosure and the quote.

01

Send the disclosure records

The large-claimant records as disclosed — oncology notes, infusion records, transplant evaluations, pharmacy history — in any format.

02

We return the read, page-cited

The diagnosis and staging as documented, the regimen actually being given, the trajectory over the disclosed period, and any documented candidacy for a high-cost therapy.

03

The underwriter prices it

Laser decisions, layer pricing, and renewal terms are the underwriter's. We never estimate future cost, project a claim, or recommend a laser.

The boundary, in writing

A read of the record, never an underwriting decision.

We read and cite what the disclosed records document: diagnosis, staging, regimen, and documented candidacy for high-cost therapy. We do not project future claim cost, recommend a laser or an attachment point, price a layer, or advise on whether to write the risk. Those are underwriting judgments.

Nothing we produce is a medical opinion about the claimant's prognosis. We carry what the treating record states, with its date and its page, and the clinical inference stays with your medical director.

Audit trail · Case #IME-4812 exportable
08:12Packet received · 342 pp / 2 packetssystem
08:3111 pages deduplicatedsystem
08:44p.140 flagged — wrong patientsystem
08:54Claim read complete · read complete · trajectory cited · cited 100%system
09:20Claim read reviewed · citations verifiedreviewer
09:26Claim read exported · underwriting file updated off-platformreviewer
Every access logged · file deleted 30 days after delivery
Why Medrecords AI

The rules the platform never breaks.

Medrecords AI EVERY LINE CITED
CASE #IME-4812 · ADAMS, T.342 pp
2/14 — ER visit, right knee p.4
4/18 — arthroscopic surgery p.61
p.140 — wrong patient quarantined
Medrecords AI
Read every page · cite every line

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.

Powered by the platform

4 capabilities behind every claim read.

The claim read is 1 deliverable of the same platform that reads, sorts, and cites the whole record.

FAQ

Stop-loss shock claim review, answered.

No. We cite what the record documents — diagnosis, staging, the regimen actually being given, and documented candidacy for high-cost therapy. Projecting cost, setting an attachment point, and deciding on a laser are underwriting judgments made by your team.

No. We carry the treating provider's documented assessment with its date and page citation. Any clinical inference about where the condition is heading is your medical director's call, made on the record we cite rather than around it.

That's the point of it. The read starts in minutes from upload rather than after a retrieval cycle, because you already hold the disclosure records. The constraint on a stop-loss renewal is reading time, and that's the part this removes.

No. Medrecords AI does not retrieve records from providers or facilities. You bring the records you already have — review starts in minutes from upload. Retrieval vendors take days; you can keep yours and still cut the review to minutes.

Send 1 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.