What is a CREB™ (Court Ready Evidence Bundle)?

A CREB (Court Ready Evidence Bundle) is the export of a member's utilization management history: the timeline, the criteria version in effect on the decision date, the source documents, a chain of custody, and a manifest a reader can check. It is built so counsel can offer the file. Here is what is in one and why each part matters.

What's inside

A CREB bundle for a given member and date range typically includes:

• The full timeline of relevant events, in the order they actually happened: authorizations, claims, denials, notices, appeals, and communications.
• The criteria applied to each determination, including the specific version of the guideline or rule in force on the decision date, since criteria change over time and the version that mattered is the one in effect when the call was made.
• Source documents attached to each event, such as clinical notes, denial letters, and appeal filings.
• A verifiable chain of custody: a cryptographic record showing the event log has not been altered since each entry was written, and who accessed which record, when.
• A manifest describing exactly what's included, its hashes, and how to independently verify the bundle's integrity.

Who asks for one

A CREB gets requested in a few recurring situations: an external review organization examining an appeal, a state Department of Insurance conducting a market-conduct exam, opposing counsel in discovery for a bad-faith or wrongful-denial claim, or a plan's own compliance team preparing for a CMS program audit.

Why "court ready" is a specific, testable claim, not a slogan

Evidence produced in litigation or regulatory proceedings is routinely challenged on authenticity and chain of custody: was this the actual record at the time, or was it reconstructed or edited afterward? A CREB is built to answer that challenge directly:

• Every event is written once, hash-chained to the event before it, in write-once storage, so a later edit to any entry is mathematically detectable.
• Every access to a record (read, export, download) is itself logged, producing an audit trail of who has touched the evidence and when.
• The bundle's manifest lets a third party independently re-verify the hash chain, without having to trust InsuredAudit's own assertion that nothing was altered.

What a CREB is not

It's not a determination of medical necessity, and it's not a legal opinion. InsuredAudit's platform captures and proves the record of decisions made by qualified reviewers under published criteria; it does not decide medical necessity itself. See what AVA can and can't do for how that boundary works in practice.