California QME & IME AI — HIPAA Compliant

QME Software California —
AI Medical Record Review

A 2,000-page medical file. An 8-hour manual review. Every finding still needing a page citation. XPndAI builds a custom AI system that classifies records, builds a source-cited chronology, and generates structured draft sections — so you focus on the medical opinion.

45 min AI review
100% source cited
HIPAA compliant
$18K starting

WHAT THE SYSTEM DOES:

📋 Classifies all document types: progress notes, ER, radiology, operative, prior QME/AME

📅 Chronology of every medical event with source page citations

✍️ Draft sections for physician to review, edit, and finalise

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The QME Record Review Problem

A typical California workers' comp QME case arrives as a 500–3,000 page PDF. Manual review takes 6–12 hours before a single word of the report is written.

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8–12 hours per case

Reading every page of every medical record to build the chronology manually. Duplicate records. Out-of-order files. Records from 10+ providers.

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Missing source citations

Defense and plaintiff attorneys will challenge any finding not tied to a specific record and page. Re-reviewing a 2,000-page file to find one citation costs hours.

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Same work, every case

Classifying record types, extracting dates, building a chronology — this is structured, repeatable work that doesn't require a physician's judgement and shouldn't take physician time.

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Cap on case volume

A QME physician reviewing 3–4 cases/week is spending 30–40 hours/week on record review alone. The ceiling is set by manual review time, not physician capacity.

XPndAI QME Workflow — 7 Steps

From raw PDF bundle to physician-ready review package. All findings cite source page numbers.

1

Ingest

Upload the complete medical record package (PDF, multi-file ZIP, or direct EHR export). System accepts scanned documents, native PDFs, and mixed-format files up to 10,000 pages.

2

Classify Documents

AI classifies every document by type: progress notes, emergency records, operative reports, radiology reports (with impressions extracted), physical therapy records, prior QME/AME/PQME reports, pharmacy records, work status notes.

50+ document types recognised
3

Extract Medical Events

Each record yields structured events: date, provider, facility, diagnosis codes, treatment rendered, medications prescribed, work restrictions. All extracted with confidence scores.

Source page cited for every event
4

Build Chronology

Dated chronological timeline of all medical events — from date of injury through present. Each entry links to the document and exact page number where it appears. Duplicates flagged, gaps in treatment highlighted.

Every entry: Record type / Date / Provider / Page #
5

Medical History Summary

Structured narrative of the claimant's medical history by body part and condition — past medical history, mechanism of injury, treatment history, current status. Physician edits and finalises.

6

Draft Section Assistance

Structured drafts for standard QME report sections based on extracted data. Physician reviews, edits, and makes all clinical determinations — causation, apportionment, work restrictions, future medical treatment. The AI assists; the physician decides.

All draft sections clearly marked for physician review
7

Physician Review & Final Output

Physician reviews and finalises every section. All medical conclusions are the physician's own. The final report is physician-generated and compliant with California DWC Title 8 requirements.

QME Companion vs. XPndAI — Different Tools

They solve different problems. Both can be used together.

QME Companion (SaaS)

  • Practice management (scheduling, billing)
  • DWC forms automation
  • Case administration
  • Does NOT automate record review
  • Does NOT build source-cited chronology
  • Does NOT generate draft sections

XPndAI (Custom Built)

  • ✓AI medical record review (500–3,000 pages)
  • ✓Source-cited chronology (page number links)
  • ✓Draft section generation for physician review
  • ✓Integrates with QME Companion and other systems
  • ✓Built to your workflow — not off-the-shelf
  • ✓HIPAA-compliant private cloud deployment

QME Software Pricing

Fixed-price projects. You own the code. No per-case SaaS fees.

Record Review AI
$18K–$28K
AI record classification + source-cited chronology + medical history summary. Standalone module, integrates with existing workflow.
Full QME Workflow System
$35K–$60K
Record review + chronology + draft section assistance + practice management integration + physician review portal. Complete end-to-end system.
IME National System
$25K–$45K
Same AI record review for IME physicians outside California. Configurable for state-specific report templates and payer requirements.

All prices USD. Scope varies; pricing confirmed after discovery call. Typical payback period: 3–6 months for a QME physician handling 4+ cases/week.

Frequently Asked Questions

What is QME software in California?

QME software helps California Qualified Medical Evaluators manage case workflow: document management, chronology building, report drafting, and DWC compliance. XPndAI builds custom AI-powered QME systems that automate the most time-consuming part — reviewing 2,000+ page medical files, building source-cited chronologies, and generating structured drafts for physician review.

Does the AI make medical conclusions or replace the QME?

No. All clinical and legal conclusions — causation, apportionment, permanent disability, future medical treatment — remain with the licensed QME physician as required by California DWC regulations. The AI handles document processing and drafting assistance only.

How is XPndAI different from QME Companion?

QME Companion is a SaaS practice management platform (billing, scheduling, DWC forms). XPndAI builds a custom AI system for the medical record review and drafting workflow — the 8–12 hour-per-case work that QME Companion doesn't automate. The two are complementary and can be integrated.

Is the system HIPAA compliant?

Yes. XPndAI builds HIPAA-compliant software with PHI encryption at rest and in transit, role-based access controls, audit logging, and BAA capability. Deployment options include private cloud (AWS US-East/West or Azure US) or on-premises. We do not use patient data to train general AI models.

Can this handle IME cases too?

Yes. The same record review and chronology system works for IME physicians nationally. XPndAI can configure the system for different jurisdictions, report templates, and payer requirements — including workers' comp, personal injury, and disability evaluations.

Schedule a Free
30-Minute Demo Call

We'll walk through your current record review workflow, show you a live demo with a sample medical file, and give you a scoped quote — all in one call.

Live demo with a real QME medical file
Scoped quote based on your case volume and workflow
BAA ready — HIPAA Business Associate Agreement available
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