Overview:

 Outsourcing vs. in-house medical record reviewing, confused on how to proceed with the medical record review services? Follow me till the end and I am sure you will say “Yes, now I know what to do”.

Before digging deep into this topic, we will quickly have a look at what does the term ‘medical record’ refer to. Imagine I am meeting with a road accident and getting injured. Obviously, I will rush to the hospital. The moment I consult the doctor, a medical chart will be generated which will be unique for me. Let us see what type of data my medical record will reflect.

  • Location of injury, signs of fracture if any
  • Previous medical history
  • Preliminary diagnosis of the physician
  • Diagnostic tests suggested by the physician
  • Medication if prescribed

In short, a Medical record is the documented storehouse of an individual’s clinical data which serve as evidence of his medical encounters. Medical record review process is the evaluation of an individual’s medical chart for medico-legal purposes.  Let me make it simpler for you. If I plan to claim compensation or insurance for personal injury, my medical record will be the first line of evidence. For the claiming process, the lengthy medical record will be reviewed and converted into an easily accessible form.

You will understand more about the process as you read further.

Importance of Medical Records Review:

Medical records review and analysis is very crucial in medico-legal cases like personal injury, medical malpractice, mass tort and worker’s compensation. They act as solid evidence for the Attorneys and paralegals to substantiate insurance claims. Health care sectors also utilize medical chart reviewing for providing better services and ensure patient safety. We will be discussing more on reviewing medical records for Attorneys.

How Medical Record Reviewing is Done?

‘Medical chart review.’ Sounds very simple right? Can’t blame you for that. But the process is not an easy one unless it is done by experts with medical knowledge. Let’s see the whole process in simple steps.

  1. Collection of medical record.
  2. Organizing the reports and collecting the misplaced records if any.
  3. Detailed study of the clinical findings in the report.
  4. Clarification with the concerned physician for any doubts.
  5. Preparation of the report with chronology.

Types of Medical Record Review Services:

When dealing with litigations associated with personal injury, medical negligence, mass tort etc., the legal firms will come across voluminous medical records. They will have two choices for reviewing the medical records.

  1. In-House Medical Record Reviewing:

The medical record review and analysis is carried out by the legal firm itself without depending upon any external agency for the process. The attorney will have his own team and they carry out the review process along with other services.

  1. Outsourcing Medical Record Review Services To Companies:

Medical charts of the claimants will be outsourced to companies that are experts in the process. These external agencies carry out the medical record review process and submit the final document to the legal firm.

Medical Record Review: In-house vs. Outsourcing:

Let us now do an in-depth comparison between both types with respect to certain parameters.

1. Expense:

Legal firms opting for in-house training will have two choices. Either they should provide training to the existing team to conduct medical records review or they should hire professionals for the reviewing process. In both cases, it will be an added cost to the attorneys. The expense to outsource the medical review services will be less when compared to that. Moreover, outsourcing expense will be based on medical records to be reviewed rather than paying the legal team as a fixed, monthly salary.

2. Expertise:

When the medical records review process is outsourced to an external agency, the review and analysis will be carried out by experts in the field. Preparing Medical Summaries, personal injury claim medical records, medical chronology etc. demands medical knowledge and this cannot be assured when in-house reviewing is opted. This will definitely be reflected in the quality of the end product.

3. Accuracy and Precision:

It is not necessary that the attorney or his team should be familiar with the medical terminologies and all the clinical details in the medical chart. Out of experience, the legal team may gain knowledge in cracking the medical data. I won’t deny that. But accuracy and precision will always be an advantage in outsourced medical reviews.

4. Infrastructure Requirement:

Can’t the attorney hire medical record review experts for his team? Definitely yes. But that would demand more infrastructure and other facilities to handle the process. This would again be an expense.

5. Speed:

Companies offering medical record review services will have a team of medical professionals who dedicate their entire work time for medical chart reviewing and analysis. It is quite obvious that the legal team cannot spend their work time completely for medical record reviewing. They will have other litigation services also to work on. Now you can compare the work speed of a legal team and an outsourcing company in reviewing medical records.

6. Data Security:

My medical record is my privacy. Data security is an important concern when it comes to medical data of an individual. A reputed company providing medical record review services will have data security infrastructure and tools. This will ensure to maintain strict confidentiality of the data. It is mandatory that companies providing medical record reviewing services should keep in compliance with HIPAA (Health Insurance Portability and Accountability Act) considerations.

Final thoughts

With this detailed evaluation, I hope you are clear that outsourcing medical record review services will always be the unsurpassed choice for reviewing medical charts. But before you outsource the medical records, make sure that the company has a consistent and efficient track record with good client testimonials. It will be an advantage if the organization is proficient in versatile litigation aspects like personal injury, mass tort, worker’s compensation and medical malpractice.