Submit a Case

Which are you?

Materials Needed For Case Submission:

For Imaging Review (X-Ray, MRI, CT):

  1. Submit DICOM images
  2. Submit corresponding radiology reports

For EMG Review:

  1. Submit a complete EMG including numerical chart data and provider impression

Steps for Submitting a Case:

  1. Download and fill out the Claim Background Form and select imaging and/or EMG review products.
  2. Provide your information below to receive the secure link to upload files.
  3. Await the link and confirmation from our Intake team.
  • This field is for validation purposes and should be left unchanged.

To get started with a review, we will need the following materials:

  1. MRI, CT or X-Ray Images (digital format)
  2. Radiology Reports
  3. Short summary of case focus
 Request a secured ShareFile upload link to provide your materials

OR

Mail your CD, Medical Reports and the Claim Background form to: 

 

Authentic4D 

Attn: Intake Team

30800 Telegraph Rd., Suite 4775

Bingham Farms, MI 48025

 

Questions?  Please give us a call at 248.469.8811 or download the How to Order document.

OR

Mail your materials to:

 

Authentic4D 

Attn: Intake Team

30800 Telegraph Rd., Suite 4775

Bingham Farms, MI 48025

 

Questions?  Please give us a call at 248.469.8811 or download the How to Order document.

Take the next step

Request a Demo

A knowledgeable member of our team will be in touch to find a convenient time to demonstrate our solution.

Submit a Case

Ready to try Authentic4D? Submit your claim file to get an evaluation within 48 hours.