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Legal Case Management - Technical Specification

Core legal case processing and membership management

Purpose

The Legal Case Management module is the central hub of the Case Clinical MedLegal Platform. Each legal case represents a patient's medical treatment related to a legal matter (personal injury, workers' compensation, etc.). Legal cases are tied to Pacific Crest Healthcare IPA memberships, generate Member Registration Numbers (MRNs), and serve as the parent entity for all medical services, claims, and financial transactions.

Key Concepts

TermDefinition
Legal CaseA patient's medical treatment case related to a legal matter
MRNMember Registration Number - Unique identifier for the membership
MembershipPacific Crest Healthcare IPA membership tied to each legal case
Case StatusCurrent state of the legal case (Active, Closed, Pending, etc.)
Accident TypeCategory of incident (Auto, Work Injury, Slip & Fall, etc.)
Date of LossDate when the accident/incident occurred
Case AccountFinancial account associated with the legal case
AuthorizationApproval for medical services under the case
SettlementFinal resolution and payment of the legal case

User Roles

RoleDescriptionPermissions
Case ManagerPrimary case management and oversightFull CRUD on cases
AttorneyLegal representation for the caseRead, Update (limited)
Case CoordinatorAssists with case administrationCreate, Read, Update
Financial AnalystReviews case financialsRead only
Medical DirectorOversees medical aspectsRead, Approve authorizations
Claims ProcessorProcesses claims against casesRead, Link claims
System AdministratorSystem-level managementAll permissions
Field NameTypeRequiredDescriptionValidation RulesRelated Entity
IDStringYesUnique case identifier (CUID)Auto-generated, immutablePrimary Key
Case NumberStringYesHuman-readable case numberFormat: CASE-YYYY-XXXXX-
PatientPatientYesPatient associated with caseMust existPatient
FirmFirmYesLaw firm handling the caseActive firm requiredFirm
AttorneyAttorneyYesPrimary attorney on caseActive attorney requiredAttorney
ParalegalUserNoAssigned paralegalValid user with paralegal roleUser
Accident TypeStringYesType of incidentEnum: Auto, Work Comp, Slip Fall, Medical Malpractice, Other-
Date of LossDateTimeYesDate of accident/incidentCannot be future date-
Date of RetentionDateTimeYesDate firm retainedMust be after date of loss-
Case StatusStringYesCurrent case statusEnum: Active, Closed, Pending, Suspended, Settlement-
Liability StatusStringNoLiability determinationEnum: Pending, Accepted, Disputed, Unknown-
Police Report NumberStringNoPolice report referenceAlphanumeric-
Insurance Claim NumberStringNoInsurance claim referenceAlphanumeric-
Opposing InsuranceStringNoOpposing party's insuranceFree text-
Opposing CounselStringNoOpposing attorney infoFree text-
JurisdictionStringNoLegal jurisdictionState/County format-
Court Case NumberStringNoCourt filing numberAlphanumeric-
Statute of LimitationsDateTimeNoLegal deadlineMust be future date if active-
MRNStringYesMember Registration NumberAuto-generated, uniqueMembership
Membership IDStringYesPacific Crest membershipAuto-generated on case creationMembership
Membership Start DateDateTimeYesMembership effective dateDefaults to case creationMembership
Membership End DateDateTimeNoMembership terminationMust be after start dateMembership
Case Value EstimateDecimalNoEstimated case valuePositive number, 2 decimals-
Settlement AmountDecimalNoFinal settlement valuePositive number, 2 decimals-
Settlement DateDateTimeNoDate of settlementRequired if status is Settlement-
Medical Lien AmountDecimalNoTotal medical liensCalculated field-
Attorney Fee PercentageDecimalNoAttorney fee rateBetween 0 and 100-
Referral SourceStringNoHow case was referredFree text-
Case NotesTextNoGeneral case notesMax 5000 chars-
Created AtDateTimeYesRecord creation timestampAuto-generated-
Updated AtDateTimeYesLast modification timestampAuto-updated-
Created ByUserYesUser who created caseValid user IDUser
Updated ByUserYesUser who last updatedValid user IDUser
AppointmentsAppointment[]NoRelated appointments-Appointment (1:Many)
AuthorizationsAuthorization[]NoService authorizations-Authorization (1:Many)
ClaimsClaim[]NoRelated claims-Claim (1:Many)
DocumentsDocument[]NoCase documents-Document (1:Many)
Case AccountCaseAccountNoFinancial accountOne per caseCaseAccount (1:1)
Medical RecordsMedicalRecord[]NoMedical documentation-MedicalRecord (1:Many)
LiensLien[]NoMedical liens-Lien (1:Many)

Workflows

  1. Patient Selection

    • Select existing patient or create new
    • Verify patient demographics
    • Confirm patient consent
  2. Case Information

    • Select law firm and attorney
    • Enter accident type and date of loss
    • Capture insurance information
    • Set initial case status
  3. Membership Creation

    • Auto-generate MRN
    • Create Pacific Crest Healthcare IPA membership
    • Set membership effective date
    • Issue membership card
  4. Financial Setup

    • Create case account in financial system
    • Set up attorney fee structure
    • Initialize balance tracking
  5. Initial Authorizations

    • Create initial evaluation authorization
    • Set authorization limits
    • Enable appointment scheduling

Case Status Management Workflow

  1. Status Transitions

    • Active → Can transition to any status
    • Pending → Requires activation approval
    • Suspended → Temporary hold on services
    • Settlement → Initiates settlement workflow
    • Closed → Final status, no further changes
  2. Status Change Validations

    • Check for open authorizations
    • Verify no pending claims
    • Confirm financial reconciliation
    • Document reason for change

Authorization Workflow

  1. Authorization Request

    • Service type selection
    • Provider selection
    • Number of visits/units
    • Date range specification
  2. Auto-Approval Logic

    • Office visits (DOS) auto-approved
    • Initial evaluations auto-approved
    • Other services require review
    • Generate authorization number
  3. Authorization Tracking

    • Track units used vs authorized
    • Monitor expiration dates
    • Alert on approaching limits

Business Rules

Case Creation Rules

  • Patient must exist before case creation
  • One active case per accident for a patient
  • Firm and attorney must be active
  • Date of loss cannot be in the future
  • MRN must be unique system-wide

Membership Rules

  • Each case gets exactly one membership
  • Membership starts on case creation date
  • MRN format: PCH-YYYY-XXXXXXX
  • Membership remains active until case closure

Financial Rules

  • Case account created automatically
  • Attorney fees calculated on settlement
  • Medical liens tracked against case
  • All financial transactions require case ID

Authorization Rules

  • All services require authorization
  • Office visits auto-approved via backend service
  • Authorization numbers are unique
  • Authorizations expire after specified period

Integrations

SystemIntegration TypePurpose
Patient ManagementDirect DatabasePatient linkage
Firm ManagementDirect DatabaseAttorney assignment
Authorization SystemBackend ServiceAuto-approval engine
Claims ProcessingDirect DatabaseClaim validation
Financial SystemDirect DatabaseCase accounting
Business CentralAPI SyncFinancial synchronization
Document ManagementFile SystemCase documentation
Appointment SchedulerDirect DatabaseService scheduling

Common Issues

IssueDescriptionResolution
Duplicate MRNSystem attempts to create duplicate MRNRegenerate with new sequence
Missing MembershipCase without membership recordRun membership creation job
Status ConflictsInvalid status transitionsReview status history, correct manually
Authorization ExpiredServices rendered after auth expirationRetroactive authorization process
Settlement DelaysSettlement amount disputesHold status until resolved

Screenshots Needed

  • Case Creation Wizard
  • Case Dashboard
  • Case Status Timeline
  • Membership Card View
  • Authorization Management
  • Case Financial Summary
  • Case Document Library
  • Settlement Calculator
  • Case Search Interface

Performance Considerations

  • MRN generation must be atomic (no duplicates)
  • Case search should support 50,000+ records
  • Status changes should cascade immediately
  • Authorization checks must be sub-second

Security Considerations

  • Attorney-client privilege protection
  • Case access restricted by firm assignment
  • Financial data encryption
  • Audit trail for all case changes
  • Document access control

Notes

  • Cases cannot be deleted, only closed
  • All case modifications are audited
  • MRN is printed on physical membership cards
  • Integration with court systems planned for Phase 2