Quality Assurance and Management in Medical Record Review

Medical record review is an important process that helps to form a clear evaluation of the various medical encounters with regard to medical malpractice and personal injury cases as well as other types of litigation. Medical review professionals have the expertise and knowledge to review all types of medical records. Usually, assistance is provided in preparing documentation for physician peer review, medical peer review, disability opinion, medical chart review and so on. The medical review process is one that demands hundred per cent quality assurance to rule out any chance of error.

The medical records pertaining to a particular case will usually be voluminous, from which the relevant data is to be extracted. The facts contained in the medical records are important for the attorney handling medical litigation, for the physician engaged in peer review and for insurance companies looking to settle claims and providing the deserving care to covered entities. One of the core tasks a medical review company undertakes is medical record organization in which all relevant medical records are collected, organized and indexed for easy perusal and for gathering important data. The info gathered is then presented as concise summaries with all important details highlighted. The professionals carrying out the medical review process include physicians and nurses apart from regular documentation staff. They review the documents in a consistent and unbiased manner so that only the correct information is presented to the end user.

Leading medical review companies focus on providing proven solutions that will ideally address all compliance requirements of their clients. They utilize state-of-the-art technology and the expertise of proficient quality control personnel to deliver quality driven services. These services help medical-legal entities, payers and other providers to improve quality and enhance revenue.

• A reliable medical record review company with considerable standing in the industry will adhere to the most rigid protocols as regards HIPAA compliance, PHI security and confidentiality, and quality assurance.
• The medical reviewers in such a medical review firm are highly knowledgeable in various medical specialties and sub specialties. This enables them to provide insightful medical reviews that are evidence based. Paramedical and medical staffs that are part of the review team will ensure the quality expected by the clients.
• Each review is subjected to a multilevel QA process.

• The first level of QA is done by the production team that will review all the documents they worked on.
• The second level of checking is carried out by reviewers who will peruse all the documents. If required they will be sent back for further checking/corrections. If the documents are error free, they are passed on to the next level.
• The third level of quality assurance is at the hands of a medical practitioner, and is done as an oversampling of all documents.

If you are discrete enough to identify and associate with a unique service provider, you really stand to benefit. The reviews you receive will be practically error free, concise and of immense utility value. However complicated the documentation in your medical records may be, such a service provider will have an excellent document management system in place that facilitates sorting and capturing the required medical chart information for review purposes.