Which type of review involves evaluation of the actual medical records by clinicians?

Which type of review involves evaluation of the actual medical records by clinicians?

• A. Medical Record Review
• B. Automated Review
• C. Non-Medical Record Review
• D. Technical Denials

Answer: (A)

Clinician-led chart review is the process of examining the actual patient records. In this approach, a clinician or team reads the chart—progress notes, physician orders, lab and imaging results, operative reports—to determine whether the documented care is accurate, complete, and justified. This hands-on review relies on professional medical judgment and direct examination of source documentation. Automated review, by contrast, relies on software to analyze data without reading full charts. Non-medical record review looks at non-clinical documents or administrative data, and technical denials refer to why a claim was denied, often due to paperwork or system issues rather than a clinician’s chart review.

Clinician-led chart review is the process of examining the actual patient records. In this approach, a clinician or team reads the chart—progress notes, physician orders, lab and imaging results, operative reports—to determine whether the documented care is accurate, complete, and justified. This hands-on review relies on professional medical judgment and direct examination of source documentation. Automated review, by contrast, relies on software to analyze data without reading full charts. Non-medical record review looks at non-clinical documents or administrative data, and technical denials refer to why a claim was denied, often due to paperwork or system issues rather than a clinician’s chart review.