What a medical record review service includes
Answer in brief: the base product of almost every review service is a page-cited medical chronology. Bookmarks, hyperlinks, sorting and a missing records list are often free; narrative summaries, deposition summaries, timelines and rush are often billed; a medical opinion is a separate, signed product priced at roughly double the chronology rate.
Limits: We have not ordered work from the services listed: prices and turnaround times are what each service publishes on its own site on the date shown, and the worked example uses a synthetic file.
The 4 layers of record review work
Every service sells some mix of 4 layers. The higher the layer, the more it costs and the more it needs a license. Know which layers you need before you ask for a quote.
Deliverables and what the published price lists say about them
Captured 2026-11-12 from the price pages of Medico Legal Request, Medilenz, RRR Health Tech, LezDo TechMed and NaviCase. "Free" means the service lists it at no charge.
| Deliverable | What it is | Published treatment | Who needs it |
|---|---|---|---|
| Medical chronology | Date, provider, event, findings, source page for every entry | The base product: $15 to $25 an hour, or $0.20 to $0.75 a page | Everyone |
| Bookmarks and hyperlinks | PDF bookmarks per provider; each entry links to its page | Free at Medico Legal Request, Medilenz, RRR Health Tech and LezDo TechMed | Anyone checking the chronology |
| Missing records list | Records referenced in the file but not in it | Free at the same 4 | IME physicians, risk teams |
| Sorting and merging | 1 PDF in date or provider order | Free at Medilenz and RRR Health Tech; $20 an hour at Medico Legal Request; $0.07 to $0.10 a page at LezDo TechMed | Anyone with a messy production |
| Narrative summary | Prose account of the course of care | Hourly at the hourly services; $0.05 to $0.10 a page add-on at LezDo TechMed | Report writers who want prose to edit |
| Billing summary | Charges by provider and date | Hourly; listed by Medico Legal Request and MRR Health Tech | Claims and risk teams |
| Treatment timeline | Visual timeline of key events | $35 to $100 per timeline at LezDo TechMed; $75 for 500 pages at Medilenz | Presentations, peer review committees |
| Deposition summary | Summary of a transcript, not records | $1.00 to $1.50 a page at LezDo TechMed | Expert witnesses |
| IME report prep | Records section and history drafted on your template | $0.50 a page, $500 minimum at NaviCase, conclusions left blank | IME physicians |
| Medical opinion | Signed opinion on causation, care or impairment | $35 to $50 an hour at the hourly services | Buyers who need an outside opinion |
What physicians should ask a service to include
A physician buying record prep before an exam or an expert review needs the file organized around the questions the report must answer. Ask for these by name in the statement of work:
- Prior complaints to the same body part, with dates and source pages. NaviCase lists this for its orthopedic and spine examiners.
- Gaps in care longer than a set number of days, flagged where they occur.
- Imaging results in date order, with the impression quoted, not paraphrased.
- Medications with start and stop dates where recorded.
- Work status and restrictions by date, for workers' comp files.
- A records reviewed list with provider, date range and page range, which California QMEs need for the declaration of pages reviewed.
- No conclusions. State that the vendor does not write causation, apportionment, MMI or impairment language. NaviCase, for example, returns IME prep with the comments and conclusions sections blank.
What hospitals should ask for in external peer review
External peer review is a different purchase: you are buying a physician's judgment on a case, not a summary. The ICAHN network's published process is a fair template for what to expect from any vendor:
- The hospital finishes its internal review and decides an outside review is needed, for example because of a conflict of interest, missing specialty expertise or a split decision.
- The hospital signs a review agreement and a HIPAA business associate agreement before any record leaves.
- A specialty-matched reviewer gets the record and a structured review form.
- The reviewer returns the form within a set time (10 working days routine, 5 expedited at ICAHN) and the record is destroyed afterwards.
- The hospital uses the findings to finish its own peer review decision.
Ask any peer review vendor for the reviewer's specialty and board status, the conflict check they run, the form you'll get back, and what happens to the record after the review.
What no service should include
- Your signature on work you didn't read. If a summary goes into a report you sign, you check it.
- Record retrieval bundled silently. Retrieval fees and timelines are separate; get them as separate lines.
- Unlabelled AI output. Ask the vendor to state which steps use AI and who checks them. See AI-assisted vs manual.
Questions about what is included
Does a medical chronology include a medical opinion?
No. A chronology reports what the records say, with page citations. An opinion on causation, standard of care or impairment is a separate product signed by a licensed physician, priced at $35 to $50 an hour at the services that publish it.
Is a missing records list usually extra?
Not at the services we read. Medico Legal Request, Medilenz, RRR Health Tech and LezDo TechMed all list missing record identification at no charge, captured 2026-11-12.
Can a review service write my IME report?
Some prepare the records section and history from your dictation on your template, such as NaviCase at $0.50 a page. The opinions stay blank for you to write, and you sign.