Explainers
Claims and medical records, and why you want both.
Insurance claims describe services billed to your health plan and how the plan processed them, including payment and member responsibility. Medical records document clinical details such as diagnoses, notes, and lab results. Flexpa retrieves available claims and clinical records from sources you connect; neither source guarantees a complete history.
Updated 2026-11-11
How it works
- Claims: billing details
- Clinical records: medical details
Side by side
| Claims | Medical records | |
|---|---|---|
| Comes from | Your health plan | Your doctors and hospitals |
| Shows | Providers, dates, services, costs, your share | Notes, labs, medications, diagnoses |
| Scope | Services reported to the connected plan | Records available from connected facilities or participating networks |
Questions
What's the difference between claims and medical records?
Insurance claims describe services billed to a health plan and the plan's payment decisions. Medical records document clinical information, such as a provider's notes and lab results. A claim can exist even if the plan did not pay it.
Why would I want both?
Claims can show billed services across providers, while medical records add clinical details such as notes and test results. Connecting both through Flexpa can add context, but available records may still be incomplete.