Faster medical record review
Faster response rate to bill of particulars
Reduction in demand preparation work
Based in New York, Schalk, Ciaccio & Khan is a personal injury and criminal defense firm that prides itself on client service and maximizing client recoveries. Anthony Ciaccio, one of the three partners, brings prior experience as a prosecutor and an insurance defense attorney. That knowledge of how prosecutors build cases and how insurance companies evaluate and resist claims helps him and his team better advocate for their injured clients.
However, as a small firm, to best represent its clients they needed to rethink their process for reviewing the thousands of pages of records they routinely received for each injury case. Medical records review became a significant bottleneck for Schalk, Ciaccio & Khan. The firm tried to hire nurses to help construct medical chronologies, but inevitably, the work fell back on internal staff. As a small law firm, there simply wasn’t enough time to thoroughly review the records.
The consequences were significant. Attorneys weren’t as prepared or confident when negotiating with adjusters. Gaps in treatment often went unnoticed until defense attorneys exploited them. And duplicative records eroded credibility with the insurers Ciaccio needed to persuade.
EvenUp was recommended by the firm’s case management system vendor, SmartAdvocate. What resonated most with Schalk, Ciaccio & Khan was how EvenUp could help the firm boost its credibility with insurers, particularly through EvenUp’s line-level citations and human-in-the-loop document review model which helped ensure content accuracy. The firm now uses EvenUp to accelerate and enhance its service from medical record review through depositions.
Before EvenUp, Schalk, Ciaccio & Khan hired and trained multiple nurses to manually prepare medical chronologies. Each nurse, however, eventually resigned, citing the tedious workload.
When the work fell back to the internal team to handle, treatment and documentation gaps and errors were missed, as busy workloads didn’t leave time for thorough reviews.
The firm now relies on EvenUp’s MedChrons™ and Medical Management™ tools to translate thousands of pages of records into actionable insights about the strengths and weaknesses of each case.
EvenUp catches what human reviewers previously missed, helping to protect the value of the case. The Missing Docs Check helps identify missing bills and records before a demand is sent. The Care Timeline and the nurse-reviewed MedChrons™ flag treatment gaps before the defense uses them to devalue the case.
MedChrons™ also identifies inconsistencies such as duplicate records or bills for treatment that lack a corresponding medical record. This extra layer of review from EvenUp’s team of medical nurses has improved the firm’s credibility with the defense.
When he was an insurance defense attorney, Ciaccio said that examiners would get frustrated by plaintiff’s lawyers who sent duplicative medical records, because they assumed it was an intentional ploy to recover more money. He appreciates that these errors are now being caught by EvenUp, as it improves his firm’s standing with insurance companies and ultimately paves the way for faster, higher settlement offers.
The firm estimates that with EvenUp, records are reviewed 10 times faster than before. The time savings extend to responding to the insurance’s bill of particulars. Ciaccio estimates that his response time is about 90% faster than it was before. What once required scattered effort across a month of reviewing ten or so medical providers now takes a single day.
Not only have they removed review bottlenecks, but the attorneys and support staff no longer have to spend evenings and weekends reviewing medical records.
With EvenUp, I'm able to work on more interesting and profitable work and no longer need to spend my Saturdays going through 10,000 pages of medical records. That benefit is hard to quantify, but it's real.
Anthony A. Ciaccio
Schalk, Ciaccio & Khan have also been able to give their support staff other work, including client communications and document review. Paralegals have more time to spend with clients and refine the demands and other legal documents generated by EvenUp. Ciaccio says that not having to pay his higher-salaried employees to do mundane work has been the best return on investment.
Having spent years on the defense side, Ciaccio understands how insurance examiners read demand packages. They are often overworked and inundated with submissions full of hyperbole that fall on deaf ears.
Ciaccio appreciates that EvenUp lets him structure demands the way defense counsel would write their own internal evaluations: factual and honest, even about the case’s weaknesses. He believes that a firm’s credibility hinges on sending an honest demand package.
Whether the firm uses EvenUp’s Express Demands™ or Expert-Reviewed Demands, approximately 90% of the demand preparation work is done before it’s sent to Ciaccio for review. With more time in his day, he can now thoughtfully review demands and make the changes in tone and formatting he believes will resonate with the defense firm.
For Ciaccio, EvenUp’s legal AI assistant, Companion™ has been instrumental in negotiations with insurance companies. When asked a question about a case, Companion™ not only answers it but also provides citations that link directly to the highlighted passage in the relevant source document. The quality and credibility of the responses allow Ciaccio to copy and paste word-for-word Companion’s answers for use in his communications with adjusters.
Companion™ doesn’t just help surface previously known information, but it has also helped Ciaccio catch inconsistencies in the records that have had a significant impact on the case. A recent example involved a case with a prior back surgery. Ciaccio discovered through Companion™ that the prior and new injuries were on opposite sides of the spine, a distinction invisible in a 900-page record but potentially worth hundreds of thousands of dollars in settlement value.
Companion has helped me open up a whole new avenue of argument in my case that the insurance company is actually weighing.
Anthony A. Ciaccio
In another high-value case, Ciaccio used EvenUp to respond to a detailed three-page letter from an experienced insurance examiner. He estimates that he refuted 95% of the examiner’s arguments using evidence from Companion™. When he called her to renegotiate, the ability to point to specific lines in the evidence that showed what the examiner had gotten wrong helped him convince her of what she had missed.
When it’s time for depositions, EvenUp helps Schalk, Ciaccio & Khan and their clients appear well-informed about the details of the case.
EvenUp’s MedChrons™ help the firm both its lawyers and its clients for depositions. The medical chronology allows them to quickly review each provider’s treatment history in a color-coded chart. Clients are often nervous before a deposition, especially about forgetting elements of their accident and treatment. The chronology serves as a useful memory aid for clients, helping them feel more confident before speaking in front of the defense.
With clients appearing confident and prepared, the defense can be more wary of a potential jury trial. This, Ciaccio says, helps strengthen the likelihood of a settlement.
For Schalk, Ciaccio & Khan, the impact of EvenUp isn’t measured in a single metric. The firm has seen quantifiable improvements in record review efficiency, as well as in its reputation among clients and insurance companies.
At case close, EvenUp creates a new client touchpoint: Ciaccio now sends clients a complete medical chronology as part of their closing letter and settlement check. He does so to demonstrate how thorough he was throughout the case and to provide the client with a tangible record of everything that transpired to arrive at their settlement.
