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EXHIBITS - PowerPoint PPT Presentation

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EXHIBITS. DEFINITION. The word ‘Exhibit’ (legal) refers to an evidence in physical form brought before the court or authorized personnel for verification. Records to be included in the exhibits.

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The word ‘Exhibit’ (legal) refers to an evidence in physical form brought before the court or authorized personnel for verification.

records to be included in the exhibits

Records to be included in the exhibits

The purpose of exhibits is for verification of information given in the demand with the pertinent medical record. The exhibits contain the following:

Traffic Crash Report

EMS /ambulatory report

ER-Physician Record

ER-Trauma Record

Diagnostic studies

Follow-up visits

Physical Therapy records

Chiropractic records

Specialty visits

Medical Bills

Medical illustrations

Wage loss details

Medical evaluations stating future treatments required

records not to be included in the exhibits

Administrative Correspondence

  • Medication List
  • Phone Call Documentation
  • Notice of Doctor's Lien
  • Correspondence
  • Claim Details
  • Case Completion Data
  • Checklists
  • Patient Registration
  • Office Policies, HIPAA Notice
  • Consent
  • Questionnaire
  • Neuropsychological Deficit Scale


Blank Page

Flow sheet

Trend report

Waveform Report

Discharge Instructions/Summary

Personal Belonging List

Physician’s orders

Signature Sheet


ECG strip

Intravenous Therapy Sheet

Physician Supplementary Certificate

Referral Form


Declaration of assets

preparation of exhibits


There should be an initial cover page with the heading in the center “ TABLE OF CONTENTS”. This should be followed by another cover page Exhibit-1. A cover page should be added between exhibits stating the number of the exhibit.

The initial exhibit should be the one giving a detailed description of the accident or injury.

Eg: The Traffic Collision Report/Police report

The following exhibits should be made hospital/provider-wise. All the record from one particular hospital/ medical provider should be an exhibit and records from another hospital /medical provider the next exhibit.

Eg: Spartanburg Medical Center =Exhibit-A

South Orange Wellness Injury Center = Exhibit – B

Medical expenses exhibit: The consolidated bill containing the total medical expenditure for the treatment rendered by the patient should be the first bill. Following this, individual bills of various hospitals to be included.