Streamlining IME Workflows: How California’s Leading Med-legal Firm Enhanced Claim Processing with Summarized, Hyperlinked Medical Records

About the client

The client is a medical-legal practice management company that offers administrative support to medical examiners during claim validation. They assist in organizing workflows to ensure efficient claims resolution.


Client challenges
  • The client needed help summarizing extensive medical histories for Independent Medical Examiners (IMEs) to evaluate claim submissions.
  • Handling medical records ranging from a few to thousands of pages presented significant challenges in efficiency and accuracy.
  • The client required a solution to review and condense these extensive records into a manageable format for IMEs to use in their evaluations.
Solution
  • We employed a 4-step process, beginning with downloading the medical records from the client’s SFTP.
  • Our team reviewed each page of the medical records using our AI/ML model, extracted the relevant details, and summarized the key medical information in chronological order.
  • The summarized documents are provided in both Word and PDF formats.
  • The PDF is hyperlinked for easy navigation and merged with the source file, linking to the respective sections for quick access to critical information.
  • The finalized, summarized files are uploaded back to the client’s dedicated SFTP.
Results at a glance
Total pages processed: 2,30,000+ 3500 pages processed per day Delivered processed records within 24 hours
Benefits
  • Quick turnaround: Our AI/ML model accelerated the medical record review process, ensuring delivery of processed records within 24 hours.
  • Reduced operational costs: Outsourcing the summarization eliminated the need for additional internal staff, saving time and resources.
  • High accuracy: Our service improved the accuracy of reviews and facilitated easy navigation and retrieval of critical medical data from the records.
Technology

PreludeSys’ MRRM (AI/ML) system for hyperlinking