Enhanced Ledger Calculations in Medical Overview

Overview

Enhanced Ledger Calculations is a feature within Eve's Medical Overview that automatically extracts and calculates financial data from medical bills and EOBs to generate an itemized economic damages ledger. This feature uses AI to extract charges, payments, and adjustments from uploaded documents, then performs dynamic calculations to show outstanding balances and total damages for personal injury matters.

How It Works

When medical records, bills, and Explanation of Benefits (EOBs) are uploaded and processed in a matter, Eve's AI automatically scans these documents to extract financial information. The system identifies provider names, dates of service, billed charges, contractual adjustments, payments received, and calculates the remaining outstanding balance for each service line.

The ledger displays this information in an itemized view with summary totals across all entries. All calculations update dynamically based on the extracted data and any manual edits or exclusions made by users. Each ledger entry includes direct links back to the source document section where the information was extracted, allowing users to verify accuracy and trace data back to its origin.

Users can edit ledger entries directly to correct extraction errors, add missing information, or update payment and adjustment amounts. Line items can also be excluded from economic damages calculations by unchecking them in the ledger view—excluded items remain visible for reference but do not contribute to totals.

The feature also monitors for missing documentation by flagging when a medical record exists without a corresponding bill, or when a bill exists without supporting medical records. When new medical documents are added to a matter, Eve alerts users that the Medical Overview can be rerun to incorporate the new information. Users can toggle between different versions of the Medical Overview at any time.

Key Terms

• Total Charges: The amount originally billed by the medical provider for services rendered.

• Adjustments: Contractual write-offs agreed upon between providers and insurers, or other modifications to the original billed amount that are not patient payments. This information is typically found on Explanation of Benefits (EOBs) documents.

• Net Charges: The amount calculated by subtracting adjustments from total charges.

• Payments Made: Payments received from insurance companies, patients, or other parties for medical services.

• Outstanding Balance: The remaining balance for a service line item, calculated as charges minus adjustments minus payments.

• Source Document Links: References from ledger entries back to the specific section of the uploaded document where the financial information was extracted.