QME record review glossary
Short version: 18 terms you meet when comparing record review services and tools as a California QME, each in 1 or 2 plain sentences, with the source where a rule is involved.
Limits: Prices, turnaround and features come from each vendor's own website, read on 2026-11-12. We did not send any vendor a real file, so turnaround and quality are the vendors' claims. Nothing here is billing or legal advice.
Evaluators and evaluations
- QME (Qualified Medical Evaluator)
- A physician or other practitioner certified by California's Division of Workers' Compensation to perform medical-legal evaluations when a workers' comp claim has a medical dispute.
- Panel QME
- A QME picked from a panel of names the DWC Medical Unit issues to an unrepresented or represented worker, as opposed to an evaluator the parties agree on.
- AME (Agreed Medical Evaluator)
- An evaluator the applicant's attorney and the defense agree on instead of using a panel. The same record review questions apply.
- ML201
- The fee schedule code for an initial or full medical-legal evaluation that is not a follow-up or supplemental. It pays $2,015 and includes review of 200 pages of records (8 CCR 9795).
- ML-PRR
- The fee schedule code for record review past the pages included in an evaluation code: $3.00 a page. This site compares vendor prices with that rate.
- ML203
- The fee schedule code for a supplemental medical-legal report, often written after new records arrive.
- Supplemental report
- A report written after the evaluation, usually to address new records or new questions. Record batches for supplementals are small, so per-page pricing and fast turnaround matter.
- Declaration of records
- A statement under penalty of perjury of the pages served on or reviewed by the evaluator. The serving party declares the page count it sends, and the evaluator's report declares the pages reviewed.
Kinds of record review vendor
- Party-side service
- A company hired by the claims administrator or an attorney to clean up records before they are served on the QME: removing duplicates and non-medical pages, indexing and declaring a page count. Lexitas and LevelShift are examples.
- Evaluator-side service
- A company or tool the QME uses to sort, index and excerpt the records received. Everything on the software page and most of the services page is evaluator-side.
- Hybrid service
- A service that runs AI on the file first and has staff check or finish the output before delivery. RapidCare WHITE, LezDo TechMed, Summit Global Services and Wisedocs describe themselves this way.
Record and output terms
- Chronology
- A date-ordered list of encounters, findings, diagnoses, treatment and work status drawn from the records, ideally with a page reference on every line.
- Page citation
- A reference from a line of the outline to the page it came from. It is what lets you check an excerpt in seconds instead of searching the file.
- Deduplication
- Finding pages that appear more than once, often because 2 parties served the same provider records, and setting the copies aside. Vendors differ on whether they bill the copies.
- Bates numbering
- Stamping every page of a record set with a unique sequential number so anyone can cite the same page.
- OCR (optical character recognition)
- Turning a scanned page image into text a tool can search and read. Faint faxes and handwriting are where OCR fails.
Privacy terms
- PHI (protected health information)
- Health information that identifies a person, which HIPAA protects. A QME file is full of it.
- BAA (business associate agreement)
- The contract under HIPAA that a vendor signs before handling PHI for you, setting out how it protects, uses and returns the data. Get it signed before any file moves.