- What does Etiology do?
- Etiology reviews medical records and billing for insurance claims payers and classifies every charge on the bill. Each charge gets two determinations: a chart determination (does the charge involve the injury complained of) and a causation screen (would the claimant have needed the care anyway), with the record page cited under each call. The work fits workers' compensation compensability, liability and medical-malpractice causation, and subrogation review.
- What does a review cost?
- A flat fee per claim file, set by the number of unique pages in the record after duplicates are proven: $2,750 up to 500 pages, $5,500 for 501 to 1,500, $8,000 for 1,501 to 3,000, $10,000 for 3,001 to 5,000, and $15,000 for 5,001 to 10,000. Files over 10,000 pages are quoted from the production at $1.75 per unique page. Rush handling is half the committed turnaround for an additional 50 percent of the flat fee. You are quoted up front from the production you send.
- How fast is turnaround?
- 1 business day for files up to 500 unique pages, 3 business days up to 1,500, 5 business days up to 3,000, 8 business days up to 5,000, and 12 business days up to 10,000. Turnaround runs from the point the complete records are in hand.
- Is there a sample review?
- Yes. A de-identified sample review is available to download as a PDF. Its names, dates, providers, and figures are fictitious and illustrative.
- How are client records handled?
- Etiology puts a written confidentiality obligation in place before any record moves. The analysis runs on Anthropic's Claude models under zero data retention terms, with no training on client data. Records are encrypted in transit and at rest, access is limited to the review, every determination is independently verified, and the working set is destroyed on a defined schedule after delivery.
- Does Etiology hold a SOC 2 or other security attestation?
- No. Etiology holds no SOC 2, HITRUST, or other third-party security attestation today, and none is in progress. It says so plainly rather than imply one, and relies on controls a client can check. When a client engagement calls for a formal attestation, Etiology will pursue it.
- Does Etiology value claims or recommend what to pay?
- No. There is no settlement valuation, no reserve or authority recommendation, and no opinion on what a payer owes. Etiology supplies the factual input, cited to the record page, and provides no legal, medical, or claims-adjusting advice.
- What is a relatedness or causation review?
- It is a charge-by-charge read of the medical record that separates the charges involving the claimed injury from those that do not, and screens whether the claimant would have needed the care regardless of the injury. Etiology answers both questions for every charge and cites the record page each answer rests on.