Prepare the practitioner’s response to a Medicare billing review or PSR referral
Key facts
- Human involvement
- RedLawyer-led
- How AI is used
- From the request and the practice’s records, build a table of the services and item numbers in the review period with the clinical record supporting each, mark where the record is missing or does not match the item descriptor, and index the documents produced. The tool writes nothing in the practitioner’s submissions or statements.
- What the lawyer must review
- The lawyer advises the practitioner on the process and risk, decides whether to offer a voluntary acknowledgement or agreement, prepares any submission and the practitioner’s own account with them, and checks that patient records are produced only as required.
- Written for / version
- US
Open a jurisdiction version of this task to see which instruments apply: US
Who does what
| Role | What they do |
|---|---|
| Assistance | Supporting preparation only. From the request and the practice’s records, build a table of the services and item numbers in the review period with the clinical record supporting each, mark where the record is missing or does not match the item descriptor, and index the documents produced. The tool writes nothing in the practitioner’s submissions or statements. The tool writes nothing into the document. Substantive advice, judgement and any restricted content remain with the responsible human. |
| Lawyer | Perform the substantive analysis and decisions. Independently check any permitted supporting work and approve the exact output for its intended use. |
Checklist
- Confirm patient health information goes only into a tool the practice has approved for health records, de-identified where the task allows, and that the output discloses no patient detail beyond what the recipient needs.
- Check each item number and date against the clinical record, not the billing extract alone.
- Confirm no tool wording has been carried into any submission or statement.
- Confirm the response deadline from the request.
Sources
- Professional Services Review, The PSR process · 2026-10-18
These are suggested working checks. Confirm the required checking with the responsible lawyer before work starts; the checking approach does not establish permission to use AI.