Do not send PHI by email or through this form. Describe the case type, injury, and the decision you need to make. Medisprudence will confirm scope, pricing, and conflict status before any records are requested.
Medisprudence reviews your submission and responds within one business day with: deliverable type, fee range, turnaround time, conflict status, and whether records are needed.
If records are needed, a BAA and engagement letter are executed before any records are transmitted. Cross-border processing is disclosed at this stage.
After secure record intake, the physician review is completed and the source-referenced deliverable is transmitted through the agreed secure channel.
Do not include patient names, dates of birth, social security numbers, medical record numbers, or other protected health information in this form or in any email to Medisprudence. PHI is transmitted only through the secure channel established after BAA execution.