# Detect tampered and deepfake Discharge Summary > A discharge summary is forged because a health insurer prices a claim from it. The admission and discharge dates set the length of stay, and the procedure and diagnosis codes set the package the claim is paid under, so widening a stay by two days or adding a procedure moves a settlement figure without touching anything else on the page. The underlying admission is often entirely real, with a handful of values rewritten before the summary reaches the insurer or the third-party administrator. **Canonical URL:** https://tampercheck.ai/documents-support/discharge_summary **API document class:** `discharge_summary` **Last updated:** 2026-10-07 --- ## What a genuine discharge summary contains A discharge summary is the hospital's account of one admission. It records the patient's name and hospital registration number, the admitting and treating consultants, the date and time of admission, the ward, the date of discharge, the presenting complaint, the final diagnosis with its classification codes, the procedures performed and the date of each, the course in hospital, the investigations carried out, the condition at discharge, the discharge medication, and follow-up instructions. It is signed by the treating physician and printed on hospital letterhead with numbered pages. Nearly every value on it is bound to a date. Procedures are performed between admission and discharge, never outside them. The course-in-hospital narrative has to account for every day the stay claims, and the discharge medication list has to match the treatment that narrative describes. Follow-up is scheduled after discharge, not before. A procedure code names a specific intervention performed by a specific surgeon, so adding a code without adding a surgeon, an operative date, and a line in the narrative produces a summary that contradicts itself in three places. ## How discharge summary forgeries are made ### Length-of-stay extension The admission date is moved earlier or the discharge date later, because room rent and daily care are billed per day. Two digits change, and the course-in-hospital narrative below them still accounts for the original number of days, leaving a stay the document's own text cannot fill. ### Procedure and diagnosis code upgrading A code is replaced with one that maps to a higher-value package, or a procedure line is added that was never performed. The inserted line typically lacks a matching operative note, a named surgeon, and a date inside the admission window, which is where adjudicators and per-field analysis both catch it. ### Treating physician substitution The attending consultant's name is changed, either to attach a specialty that justifies the procedures claimed or to move the summary away from a clinician the insurer might contact. The replacement name is usually set in a slightly different weight from the signature block it sits above. ### Ghost admissions on cloned letterhead A hospital's letterhead, stamp, and summary layout are reproduced to document an admission that never happened. Nothing is edited, so there are no local inconsistencies to find, and the analysis turns instead to whether the letterhead and stamp were printed with the page or composited onto it. ### Page substitution within the summary One page of a multi-page summary is replaced with a rewritten version while the rest of the file stays genuine. Page numbering, the repeated patient identifier in the header, and the continuity of the narrative across the page break are the checks that expose it. ## What TamperCheck checks on a discharge summary TamperCheck runs 200+ forensic checks across three layers and returns a risk score from 0 to 100 with plain-English findings tied to specific regions of the document. These three carry the most weight on this document class. ### Letterhead, logo, and issuer plausibility Issuer branding is checked for resolution and compression consistency against the body text it sits on. A logo lifted from a website carries the signature of its source, not of the document. ### Date and validity consistency Issue, expiry, and period dates are checked against one another and against the file's own creation metadata, which catches backdating and validity extension. ### Reference and document number checks Document, account, and reference numbers are checked for issuer format conformance and against every other place the same value appears on the page. ### And many more checks The three above are the layers that carry the most weight on a discharge summary. Every upload runs the full suite of 200+ checks regardless of document class, spanning file structure and metadata, pixel-level forensics, font and text rendering, optical and print characteristics, provenance signals, AI-generation signatures, and many more checks. ## Who verifies a discharge summary, and why Health insurers and TPAs adjudicating medical claims. In each case the document is being used to unlock money, access, or a legal status, which is exactly what makes it worth forging. ## How to verify a discharge summary in 4 steps 1. **Check the fields against each other.** Read admission and discharge dates, diagnosis codes, and treating physician together rather than one at a time. Forgers typically change one value and leave the rest of the document describing the original. 2. **Inspect the file metadata.** Open the document properties and look at the producer, creation date, and modification date. A document produced by a consumer PDF editor, or created long after the date printed on its face, is worth a closer look. 3. **Ask for a second document.** Request a corroborating document from the same issuer or an adjacent period. Forgery effort concentrates on one file, so inconsistencies surface as soon as there are two to compare. 4. **Run a forensic check.** Manual review catches obvious edits but not field-level pixel manipulation or synthetic generation. TamperCheck runs 200+ forensic checks on a discharge summary and returns a risk score from 0 to 100 within seconds, at $0.50 per document. ## Frequently asked questions ### How do insurers detect fake discharge summaries? Insurers and TPAs reconcile the summary against the rest of the claim file, checking that the length of stay matches the room-rent billing, that every procedure code has an operative note and a date inside the admission window, and that the treating consultant is on the hospital's staff. Forensic screening runs first on high-volume portfolios and flags the summaries whose dates or codes were printed later than the page around them. ### Can a hospital discharge summary be forged? Yes, and it is one of the highest-value document forgeries in health insurance because the summary is what the claim amount is calculated from. The common version is not a fabricated admission but a real one with the dates widened or a procedure code upgraded, which leaves the letterhead, stamp, and signature genuine and only a few characters altered. ### What fields on a discharge summary are edited most often? Admission and discharge dates, diagnosis and procedure codes, and the treating physician's name account for most of it, because those three drive the payable amount. TamperCheck reports findings tied to specific regions of the document, so a flagged summary comes back naming the field that moved rather than a verdict on the page as a whole. ### How long does it take to check a discharge summary? About a minute per document. A summary is uploaded as a PDF or a scan through a single REST endpoint and comes back as JSON with a risk score from 0 to 100 and region-level findings, at $0.50 per document with no subscription or minimum, which is what makes it practical to screen every claim rather than a sample. ## Related document types - Medical Certificate: https://tampercheck.ai/documents-support/medical_certificate - Medical Report: https://tampercheck.ai/documents-support/medical_report - Lab Result: https://tampercheck.ai/documents-support/lab_result - Prescription: https://tampercheck.ai/documents-support/prescription - Health Insurance Card: https://tampercheck.ai/documents-support/health_insurance_card - Vaccination Certificate: https://tampercheck.ai/documents-support/vaccination_certificate --- Try TamperCheck now: https://tampercheck.ai/dashboard · Docs: https://tampercheck.ai/docs · Pricing: https://tampercheck.ai/pricing