The medical documents a claimant as well as the insurance, legal, and medical firms interact with that are involved in the claim can be extensive, lengthy, and span lengths of time and multiple interactions with the healthcare industry. These medical documents create the medical summaries and chronologies required when filing a claim.

You may be familiar with a medical summary. The majority of individuals in North America have some form of medical summary, whether that be an electronic health record (EHR) or a paper document. A medical summary tracks a patient’s medical history comprehensively, including medical treatment, conditions, and prescriptions. A medical chronology, by contrast, is designed to be more concise and insightful for use as it pertains to litigation cases, such as those involved in the claims process. Let’s go into detail about what medical summary and medical chronology files are and how they are used.

What type of health data is reviewed in the claims process?

Every time you go to the doctor’s office, hospital, or other primary care physician, the healthcare provider(s) you interact with document your medical history in a comprehensive file referred to as a health record or documentation. This health record documentation includes medication information such as doses and types of medicines, medical conditions, and the treatments given. Medical professionals maintain an all-inclusive record of diagnoses and tests, including cholesterol, blood, and urine, among others. They also maintain document processing of surgeries, hospital summary discharge, and devices like pacemakers and hip replacements. These documents are often spread across your various interactions with healthcare professionals and lack consolidation.

‍

What is a Medical Summary?

When building a claims case, you need access to health records in order to create an effective medical summary. A medical summary is a condensed version of the health records that pertain to the case. The medical summary is typically prepared by those who interact with the medical records for the sake of the claims case, such as a legal nurse consultant for use by the attorney in settling cases. The summary concisely describes the incident and how the claimant was impacted. The goal of the medical summary is to provide information to insurance, legal, medical, and other firms involved in the case about the claimant’s health impact overall. 

‍

What is a Medical Chronology?

A medical chronology is a simplified report relevant to litigation and claims cases. It details the patient’s history in chronological order and offers insight. The medical chronology is designed to provide the claimant’s medical history in chronological, or time-based, order so that it is easy to review what incidents occurred at what dates and times that may impact the case or the outcome of the claim. A medical chronology must be concise and contain facts without opinions or bias from medical professionals.

In 2009, Congress spurred the adoption by hospitals and doctor’s offices with the Health Information Technology for Economic and Clinical Health Act (HITECH), which offered financial incentives for providers who used centralized systems. Since the act came to fruition, medical data exchange proficiency has increased by 90%. In 2016, Congress passed the 21^st Century Cures Act, ensuring that Electronic Health Record Systems (EHRs) gather information in a centralized location for easier data-sharing. Software solutions that support medical record reviews across the insurance ecosystem serve as digital translators and organization databases for professionals in healthcare, insurance, and litigation, as well as Independent Medical Evaluators (IMEs). 

Wisedocs offers medical summaries and medical chronologies for medical and health records in claims cases

The Wisedocs platform automatically generates medical chronologies that allow organizations to process claims in hours. With our automatic medical chronologies feature, companies can sort and organize medical records by date, service provider, title, and document category with ease. Our intelligent Character Recognition (ICR) leverages proprietary AI to produce documents and make medical records searchable. This technology allows paper, handwritten, and other unstructured documents to be translated into electronic data for easy searchability. Our machine-learning model has been trained to decipher complicated and integral medical information. These industry-leading features allow the claims ecosystem to automate the medical record review process and procedures while ensuring the accurate and prompt organization of medical summaries and chronologies.