Payer Compliance
Be audit-ready on every claim
Ensure every chart proves medical necessity and services performed–before payers come calling.
The Problem
Don't be exposed to payer scrutiny
Billing & Utilization Red Flags
Audits may trigger if you have a high volume of specific CPT codes, have higher utilization compared to peer practices, or submit duplicate or overlapping claims.
Subtle Documentation Issues
Charts with incomplete treatment plans, progress notes not supporting medical necessity, or missing signatures can put you at risk of failing an audit.
Payer Policy & Regulatory Compliance
Even with the right CPT codes, failure to meet prior authorization requirements or noncompliance with state or federal regulation may put you at risk.
The Solution
AI Chart Review for Payer Compliance
Reduce Audit Exposure
Charta AI validates each billed service as justifiable and documented by reviewing 100% of your charts.
Prevent Clawbacks
Catch coding errors, missing assessments, and other payer-required elements during the pre-bill review.
Standardize Quality
Give real-time feedback to your providers, directly from Charta’s AI platform. Ensure consistent documentation across the organization.
How Charta Health Works
Step 1
Customize your Charta AI environment
Define your clinical and billing audit criteria with your Charta AI Engineer, who will train the AI model to be customized to your organizational needs. Your dedicated AI Engineer will regularly train your environment, based on the feedback that your providers and RCM teams send back to us.
Step 2
Conduct pre-bill reviews on 100% of your charts
Charta will pull records directly from your EHR, and review 100% of the charts, progress notes, and any other documentation in real-time. We will not only verify that each diagnosis supports the billed service and identify documentation gaps, but also provide detailed reasoning and corrective recommendations if any part of the review fails.
Did we mention our AI is particularly good at reading scribbles?
Did we mention our AI is particularly good at reading scribbles?
Step 3
Automate corrections and generate claims
After the chart review is complete, you can choose to send corrections directly back to the EMR to automatically update the charts or flag charts for manual approval by a billing or RCM lead. AT this point, we can also generate a claim file and push the 837 to the clearinghouse.
Charta can also compile comprehensive, recurring reports on missed revenue and coding trends to gain insight into systemic issues–creating a continuous feedback loop that improves coding accuracy, compliance, and overall revenue capture across the organization.
Charta can also compile comprehensive, recurring reports on missed revenue and coding trends to gain insight into systemic issues–creating a continuous feedback loop that improves coding accuracy, compliance, and overall revenue capture across the organization.
98.2%
Charta's AI audits your patients' medical charts 98.2% cheaper than human auditors.
*Based on the average annual salary of medical billers and coders in the US.
FAQs
Frequently Asked Questions
Upload a sample batch of your past charts and billing claims to see coding opportunities our AI could have captured. Review and evaluate the results yourself before paying a penny.
Is Charta HIPAA, SOC 2 and GDPR compliant?
Yes, Charta is HIPAA, SOC 2 and GDPR compliant. You may request a copy of our compliance reports at anytime by emailing compliance@chartahealth.com.
How can I ensure my existing billing and clinical standards are followed when using AI?
Charta's AI uses advanced language models, custom-built with modern healthcare billing knowledge. Our implementation team will work closely with you during your onboarding period to learn from your feedback until you are confident our AI is following your standards precisely and consistently.
Does Charta offer any kind of free trial period?
Yes, absolutely! We are very confident that our AI will be able to create significant positive ROI for your practice. Thus, we'll happily work with you to define a free trial period together where you can confidently evaluate our technology before making any long-term financial commitments.
How do I connect my EHR with Charta?
Charta has hundreds of built-in integrations with EHRs, clearinghouses, and billing providers. It's highly likely Charta already integrates with your EHR system, automatically streaming in your charts within minutes. If not, we will happily custom-build the integration free of charge.
Does Charta provide any reporting or analytics on individual provider performances?
Yes, Charta provides both real-time dashboards and downloadable spreadsheets on how each of your providers are performing based on your clinical and billing audit criteria.
Integrating Charta Health was an easy solution. Their platform seamlessly consolidates diverse clinical and billing data into one intuitive interface that accurately pinpoints missed coding opportunities — boosting provider value and reducing coding errors that could lead to claim denials.”
Documentation review time was cut by at least 25%... instead of spending 25–30 hours per week reviewing documentation, spending more like 15 to 20 hours per week. Just because you're really focusing on the high-priority things that have been flagged—things that may be an issue for fraud, waste, and abuse.”
You basically have changed the entire work capabilities of our clinical management team. So that to me is huge.
Nobody wants to sit in an office and do workflow. That's not why people become therapists.”
Their platform helps us proactively identify documentation opportunities—such as unsupported or missing codes and E/M leveling inconsistencies—before they affect billing or audit readiness, ultimately improving the provider, payor, and patient experience. What’s been most valuable is that we’ve increased our internal pre-bill review coverage by 90% without needing to add additional QA staff.”
We didn’t even realize it could be this much better. The ability to audit 100% of claims prepayment, prevent denials, and scale efficiently has been a game-changer.”
