Ensure Documentation Integrity
Burse identifies billed conditions that lack sufficient documentation for compliant capture and flags diagnoses that may be overbilled, helping organizations strengthen documentation integrity and reduce audit exposure.
Documentation gaps on billed conditions
Identify billed conditions where the patient has the condition, but the provider documentation does not sufficiently meet MEAT requirements for compliant capture.
Overbilled conditions
Identify coded and billed diagnoses that are not clinically supportable from the record because the patient does not have the condition.
RADV exposure simulation
Burse can simulate current-year RADV exposure using a 10-fold sample of 35 patients to estimate potential audit penalties and help quantify documentation and coding risk.
Documentation integrity is what turns a clinically supported condition into compliant, defensible capture — while also surfacing billed diagnoses that may create unnecessary audit exposure.