LNCtips.com: Cross-Referencing Medical Records
As a new legal nurse consultant, you may be asked to cross-reference medical records. Cross-referencing means that you compare two sets of a provider's medical records to see if they are the same.
Duplicate sets of medical records are common. Your attorney might get medical records by an authorization, by a subpoena, from a response for a request for production, and/or as exhibits from a deposition or the opposing attorney in preparation for trial. While all the sets may truly be duplicates, you won't know if they are unless you cross-reference them.
Cross-referencing saves you time. For example, let's say that you have two sets of medical records that seem to have the same number of pages. You've already fully reviewed one set of medical records and it took you three hours. You cross-reference the second set of medical records which takes you 15 minutes. You find that the second set of medical records has 10 more pages so you review those pages in 30 minutes. You just spent 45 minutes reviewing records that might have taken you three and one-half hours to review if you hadn't cross-referenced them.
Cross-referencing saves the attorney money. The attorney (or insurance company if it's a Defense client) is always interested in keeping litigation costs as low as reasonable. In the case cited before, attorneys would rather send their experts 10 additional pages to review than have the experts re-review an entire set of medical records.
Cross-referencing is straight forward. Place one set of paper medical records on the left and one on the right and compare them. Cross-referencing of electronic medical is also possible using a dual or split screen monitor, with one set of electronic records on the left and one on the right. Whether you're reviewing paper or electronic records, look at each set page by page to see if the records are the same or if they are different. If you compare the last word of each line, you won't have to read each page. But be careful. Sometimes a page has initials or comments on it while its corresponding page doesn't. Or one page has fax information at the top while the other doesn't. And you will often find pages in one set that aren't in the other.
If you find new records or pages that don't match, tag them, review them and bring them to the attorney's attention. Some attorneys compile a working copy of the medical records which includes all pages of a medical record, no matter what the source. If that's the case, place a copy of all the tagged pages into the working copy's binder. For other attorneys, just tagging the records is enough.
As you can see, cross-referencing can save time and money. Plus it's easy to do.