# Claims Review Standardization for TPAs — Medrecords AI > Hit every SLA, standardize quality across every desk and client, and walk into renewals with the audit trail that proves it. Canonical page: https://medrecords.ai/solutions/tpas/ --- New — **Missing Records Detection:** flags every visit, provider, and date missing from the file. [See how →](https://medrecords.ai/product/missing-records-identification/) [Home](https://medrecords.ai/) ›[Solutions](https://medrecords.ai/) › — TPAs & Case Management Medical record review for TPAs ## One standard of review: across every client program. For TPAs and case management teams, Medrecords AI applies one standard of review across every client program: hit every SLA, standardize quality across every desk and every client, and walk into renewals with the audit trail that proves it — per-file cost metered for bill-back, client audit exports assembled in one click. [Book a demo](https://medrecords.ai/demo/) [Estimate Your ROI ](https://medrecords.ai/plans/self-service/) Program board · all clients SLA view Acme Insurance — 14 files · 24h SLA — 6h avg Beta Mutual — 9 files · 48h SLA — 11h avg Gamma Fund — 22 files · 24h SLA — 8h avg Client audit — Beta program, export assembled — One click Per-file cost metered for bill-back — by program Renewal-proof: the SLA record, on the record The status quo TPAs run client programs with different rules, formats, and SLAs. Manual review makes every file bespoke: *slow to turn, hard to standardize, and harder to defend at audit.* every client measures turnaround differently all of them measure it 1 audit finding can cost the program ### 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 11 — Date of injury — incident report Apr 02 — Progress Note May 22 — Gap in care · 47 days, no treatment Jun 01 — Billing statement — CPT 99214 Jul 17 — Consultation 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 · 4 — Match similarity Billing Statement — multiple — Review Consultation Report — 84% — Review Wrong claimant — J. Roe — co-mingled — Separate 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 · live — Claim #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 third-party administration. Your product is consistent, defensible service. Medrecords makes every file meet the same standard — whatever the client, line, or desk. 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 One DICOM study Organized record — by provider · date 01 — Jul 17 — Medical Records 02 — Jul 17 — Billing Statements 03 — Aug 06 — Physician Notes 612 pp indexed · every row cited — open the case → #### Hit SLAs on every file Files arrive organized, deduped, and summarized in hours — so turnaround commitments hold even when referral volume spikes. #### Client-ready, audit-ready output The same structured, cited deliverable across every program — easy to report on, easy to audit, and easy to show in the next RFP. Who this is for ### Every client measures your turnaround differently. All of them measure it. TPAs win on consistent service. Medrecords makes every file (any client, any line) arrive organized, summarized, and cited, so SLAs hold and audits read clean. Files organized and summarized within hours of referral The same cited standard across every client program Audit-ready output you can show in the next RFP Client programs · today all on SLA Acme Insurance — 14 files · 24h SLA — on track Beta Mutual — 9 files · 48h SLA — on track Gamma Fund — client audit request — export ready New program onboarded — same standard — day one Every client, the same defensible deliverable The objection ### "Can we white-label the output for our clients?" Yes. Client-ready, branded deliverables per program (your logo, your format) with per-file cost metering for clean bill-back. Your clients see your standard; the platform stays invisible. 100% SLA compliance in the pilot quarter "We put the audit trail in front of the client at renewal. That conversation used to be defensive — now it's the pitch." VP Operations · national TPA 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 [ — IME Physicians — Defensible IME opinions, faster](https://medrecords.ai/solutions/medical-evaluators/) [ — Claims Adjusters — Triage and settle sooner](https://medrecords.ai/solutions/insurance/) [ — Defense Lawyers — Surface the case-deciding fact](https://medrecords.ai/solutions/legal/) [ — Legal Nurse Consultants — Chronologies in a fraction of the time](https://medrecords.ai/solutions/legal-nurse-consultants/) [ — Expert Witnesses — Cited opinions, not paper chases](https://medrecords.ai/solutions/expert-witnesses/) [ — Life Care Planners & Vocational Experts — Cost projections built on the full record](https://medrecords.ai/solutions/life-care-planners/) [ — Social Security Disability Representatives — Years of records, one hearing](https://medrecords.ai/solutions/disability-representatives/) [ — Forensic Psychological Evaluators — Your report format, fully cited](https://medrecords.ai/solutions/forensic-psychological-evaluators/) Organizations [ — Insurance Carriers — Scale review across every claim](https://medrecords.ai/solutions/insurance-carriers/) [ — Law Firms — Litigation-ready case files](https://medrecords.ai/solutions/law-firms/) [ — TPAs & Case ManagementYOU ARE HERE — Standardize across clients](https://medrecords.ai/solutions/tpas/) [ — Government & Public Sector — Compliant, auditable records](https://medrecords.ai/solutions/government/) [ — IME Companies & Networks — One pipeline, every physician](https://medrecords.ai/solutions/ime/) [ — Self-Insurers — Claims reviewed like a carrier would](https://medrecords.ai/solutions/self-insurers/) [ — Disability Insurers — LTD/STD files, cited every cycle](https://medrecords.ai/solutions/disability-insurers/) [ — Settlement Administrators — Tier claims at MDL scale](https://medrecords.ai/solutions/settlement-administrators/) [ — VA C&P Exam Contractors — C-files, exam-ready on time](https://medrecords.ai/solutions/va-cp-contractors/) [ — Hospital Risk Management — Know the chart before counsel does](https://medrecords.ai/solutions/hospital-risk-management/) [ — Litigation Funders — Underwrite the file, not the pitch](https://medrecords.ai/solutions/litigation-funders/) [ — Medical Funders & Lien Networks — Fund the treatment, verify the file](https://medrecords.ai/solutions/medical-funders/) Use Cases [ — Social Security Disability — Timeline ready before the hearing](https://medrecords.ai/solutions/social-security-disability/) [ — Personal Injury Plaintiff — Cited evidence on demand](https://medrecords.ai/solutions/personal-injury-plaintiff/) [ — Personal Injury Defense — Verify specials, flag the gaps](https://medrecords.ai/solutions/personal-injury-defense/) [ — Veteran Disability — Timeline built before the exam](https://medrecords.ai/solutions/veteran-disability/) [ — Workers' Compensation — Track treatment and gaps](https://medrecords.ai/solutions/workers-comp/) [ — Mass Tort — Qualify claimants at scale](https://medrecords.ai/solutions/mass-tort-case-review/) [ — Medical Malpractice — Reconstruct the timeline](https://medrecords.ai/solutions/medical-malpractice/) [ — Auto Bodily Injury Claims — Specials and causation, cited](https://medrecords.ai/solutions/bodily-injury-claims/) [Not sure which fits? Talk to us about Enterprise ](https://medrecords.ai/demo/) ### Benchmark one client program. Run 30 files. Compare turnaround and findings against your current process. [Book a demo](https://medrecords.ai/demo/) [Test a file ](https://medrecords.ai/test-a-file/?src=solutions-tpas) ### More solutions - [**One written report. Per defendant. From the same 3,000 pages.** — Page-cited record review for Illinois 735 ILCS 5/2-622 affidavits — one written report per defendant, from a…](https://medrecords.ai/solutions/illinois-certificate-of-merit/) - [**Onset to the day — because the Table is measured in hours.** — Record review for VICP petitions. Complete-record assembly and onset chronology built to the Vaccine Injury…](https://medrecords.ai/solutions/vaccine-injury-record-review/) - [**Prep the opinion. Not the paper chase.** — Turn the full record into a cited chronology before your retention letter is a week old. Built for testifying…](https://medrecords.ai/solutions/expert-witnesses/) - [**Reconstruct the clinical timeline, hour by hour.** — Standard of care turns on sequence. Medrecords rebuilds the record in strict order — every event cited to its…](https://medrecords.ai/solutions/medical-malpractice/) - [**Review reports, affidavits, motion papers — AI-drafted, attorney-signed.** — Review reports, affidavit support, and motion drafts produced from the structured record in minutes, every…](https://medrecords.ai/solutions/legal-support-services/) - [**Rule 9(j) is pleaded in the complaint. There is no cure after the fact.** — Page-cited record review for North Carolina Rule 9(j) certifications — the records reasonably available…](https://medrecords.ai/solutions/north-carolina-certificate-of-merit/)