01 / Independent analysis
Medical Necessity & Utilization Review
Was the care supported by the clinical presentation and documented progress?
Evaluate whether diagnostic testing, treatment selection, frequency, duration, referrals and continued care are supported by clinical findings and relevant evidence.
- Diagnoses, examination findings and clinical rationale
- Treatment selection, frequency and duration
- Diagnostic testing, reassessment and referrals
- Patient-reported function, response to treatment and outcomes
02 / Independent analysis
Reasonableness of Medical Charges
Are the billed amounts reasonable for the services provided?
Assess identified billed charges using a stated methodology, appropriate reference information and the limits of the available data, distinct from a review of clinical necessity.
- Services, dates of service and billing codes
- Relevant charge and reimbursement references
- Benchmark selection and methodological limitations
- Specific charges requiring support or further explanation
03 / Independent analysis
Texas §18.001 Counter-Affidavit Review
What does the evidence support about disputed necessity or charges?
Consider Texas Civil Practice and Remedies Code §18.001 assignments individually, subject to case fit, professional qualifications, conflict review, applicable requirements and written engagement.
- Specific services and charges at issue
- Clinical evidence relevant to medical necessity
- Charge reasonableness using a defined method
- Clearly stated conclusions and limitations
04 / Independent analysis
Causation & Aggravation Analysis
What does the evidence support about the alleged injury?
When included in the engagement, assess injury chronology, prior history, clinical findings and alternative explanations. A temporal relationship or abnormal image alone does not establish causation.
- Reported injury mechanism and chronology
- Baseline symptoms and pre-existing conditions
- Diagnostic imaging and clinical correlation
- Potential aggravation or exacerbation and evidentiary limitations
05 / Independent analysis
Documentation & Diagnosis Review
Does the record support the diagnoses and treatment decisions?
Review whether clinical complaints, examination findings, diagnoses, treatment plans, reassessment and functional outcomes are reasonably supported in the documentation.
- Diagnosis and examination support
- Consistency between reported and objective findings
- Treatment rationale and reassessment
- Functional measures, gaps and internal inconsistencies
06 / Independent analysis
Independent Case Consultation
Need a focused answer rather than a full report?
Offer scoped clinical consultation for spine and injury record questions. The requested deliverable, record materials and questions are agreed before substantive review.
- Case-fit and clearly defined clinical questions
- Record organization and chronology
- Clinical issues and documentation gaps
- Written or verbal consultation as agreed