Inside the Coverage Advisory: How WoundScribe Flags Missing Criteria in Real Time
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A deep dive into the pre-signature advisory that reads procedure, diagnoses, and encounter fields against Medicare coverage rules before you sign.
Most documentation tools check for completeness after the fact. The coverage advisory checks before signature — while the patient is still in front of you.
What the advisory reads
The advisory ingests three things from the encounter: the procedure you picked (debridement, NPWT, skin substitute, TCC, HBO, topical oxygen), the ICD-10 diagnoses on the patient record, and the fields the ambient scribe captured during the visit — perfusion status, wound bed, days of failed conservative care, infection findings.
What it checks against
Each procedure has its own coverage pathway. For skin substitutes, the advisory looks for four weeks of documented failed standard care, a wound free of active infection, and adequate perfusion. Switch the procedure to negative-pressure wound therapy mid-visit and the checklist updates automatically — different pathway, different billing code, different required fields.
What the clinician sees
A plain-language panel: what's present, what's missing, what to add. Not a pop-up modal that blocks work. Not an autopilot that overwrites your judgment.
Where it stops
The advisory never denies a service, never blocks self-pay, never rewrites your assessment. You sign; the note goes out clean or you decide to send it anyway with a self-pay path.
See how it plugs into the AI-powered EMR for wound care and WISER claims and compliance.