The IMR packet, built to the guideline section it turns on.
Utilization review record packets assemble one disputed treatment request and its fifty to three hundred pages of support: indexed, deduplicated, and cited to the MTUS section and formulary entry the dispute turns on, before the file reaches the physician reviewer. We organize and cite the record. The reviewer decides medical necessity.
The guideline is published. So is the scoreboard.
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. California utilization review has both, in statute and in regulation, down to the guideline edition.
It also has something almost no other case type has: an annual, public result. The state publishes how often the reviewer disagreed with the denial, so the quality of what was submitted is measured in the open.
One request. Three hundred pages of context.
A single utilization review dispute travels with 50 to 300 pages, 175 in the middle of the range. The dispute itself is narrow: one requested treatment, one denial or modification, one guideline section. Everything else in the packet exists to show whether the record supports it.
The pages rarely arrive in one clean production. They come as several: the treating physician's chart, the requesting report, prior authorizations, imaging reports, pharmacy history. The same progress note appears in three of them. Older chart notes are handwritten. Scans of scans lose the dates in the header. In the demo case, 342 pages across 2 packets reduced to 27 documents once 11 duplicate pages came out and page 140, which belonged to a different patient, was quarantined.
The volume is not a rounding error. DWC's 2026 IMR report counts 152,351 final determinations in 2025, from 201,037 applications received, and upstream California utilization review decisions run roughly twenty times that.
Four steps, starting with one real file.
Send one real file
One disputed request with the productions behind it, as you already have them, in whatever formats they arrived in. Handwriting, faxed scans, and duplicated progress notes included.
We return the read
A sorted, deduplicated packet with the record evidence indexed against the guideline section the request cites, every line traced to its source page. You check it against the file you know.
We scope the build
Your packet template, your index order, your guideline set, your turnaround clock. If your volume or your rules make the build unworkable, we say so instead of shipping something that misses.
You run it
Your clinical operations team runs the packets and your reviewers decide. We never decide medical necessity, grade a request, or predict what a determination will say.
Nearby in workers' compensation: California QME record review and impairment rating record review.
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 record packet.
The utilization review packet is one deliverable of the same platform that reads, sorts, and cites the whole record.
Document Sorting & Packet Builder
Several productions sorted into one indexed packet, in your order, with duplicates and wrong-patient pages pulled out before assembly.
Medical Chronology
The conservative-care history a guideline section asks about, built as a timeline the reviewer can read in one pass, synced to every source page.
Literature & Standard-of-Care Matching
The guideline section and published literature a request points to, put beside the record evidence that speaks to it. The reviewing physician still applies it.
Verifiable AI Citations
If we can't cite it, we don't say it. Every line in the packet index links back to the page range it was pulled from.
Utilization 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.