AI-POWERED QA/QI REVIEW

Analyze 100% of Reports.
Catch 100% of Issues.

Transform manual chart reviews into automated intelligence. Our AI analyzes every report for compliance issues, billing opportunities, and quality metrics—catching problems even experienced reviewers miss.

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From Random Sampling to Complete Coverage

Finally, true quality assurance that reviews every single report

Traditional QA/QI relies on reviewing 5-10% of reports, hoping to catch systemic issues through random sampling. But what about the 90-95% that go unreviewed? Critical compliance failures, missed billing opportunities, and liability risks hide in those unchecked reports.

CareSwift's AI-powered QA/QI system analyzes 100% of your reports—whether they come via automated fax, email upload, ePCR integration, or manual submission. Our advanced algorithms examine each report against 500+ prebuilt rules plus your custom requirements, identifying issues that even experienced reviewers might miss while tracking provider performance trends and training opportunities.

Comprehensive Analysis That Transforms Your Operations

  • Revenue Optimization & Billing Intelligence

    Identify missed billable procedures and incomplete documentation that causes denials. Validate medical necessity, ensure proper mileage documentation, and catch missing signatures. Recover an average of 23% in lost revenue through comprehensive billing analysis.

  • Intelligent Deep Analysis

    Our AI analyzes 100% of your ePCRs—not just random samples. Every field is examined, data is cross-referenced, and clinical reasoning validated. Catches contradictions humans miss, identifies documentation patterns, and ensures complete protocol compliance across all reports.

  • Comprehensive Compliance Framework

    Ensure adherence to NEMSIS, NEMSQA, state regulations, and payer requirements in every report. Automated validation against 500+ prebuilt rules plus your custom protocols. Track compliance trends and identify systemic issues before they become citations.

Advanced Intelligence for Every Aspect of Quality Review

Over 500 prebuilt rules plus unlimited custom configurations

Compliance Validation

  • NEMSIS 3.5 field requirements
  • NEMSQA quality indicators
  • AHA Mission Lifeline metrics
  • State-specific regulations
  • Payer-specific documentation
  • Regional protocol adherence

Clinical Intelligence

  • Treatment justification analysis
  • Medication-allergy verification
  • Vital sign trend validation
  • Protocol deviation detection
  • Physiological outlier flagging
  • Clinical reasoning assessment

Revenue Optimization

  • Missing billable procedures
  • Incomplete mileage documentation
  • Medical necessity validation
  • Insurance-specific requirements
  • Signature completeness
  • Transport justification review

Cross-Field Validation

  • CAD vs ePCR discrepancies
  • Timeline consistency checks
  • Intervention-outcome matching
  • Location-service validation
  • Chief complaint alignment
  • Disposition appropriateness

Provider Analytics

  • Documentation time tracking
  • Narrative quality scoring
  • Peer performance comparison
  • Error pattern identification
  • Training need detection
  • Compliance rate trends

Risk Management

  • High-liability case flagging
  • Refusal documentation review
  • Consent verification
  • Documentation fraud detection
  • System abuse patterns
  • Anomaly identification

Automated QA/QI in Four Powerful Steps

From report submission to actionable insights in minutes

  • 1.Automated Report Ingestion

    Reports flow into the system through your preferred method—auto-fax recognition, email parsing, direct ePCR integration, or bulk upload. Our system can extract all data with complete accuracy from handwritten notes, scanned forms, and digital reports. No manual data entry required.

    Report Ingestion Center

    Status: Active Processing
    Auto-Fax Import

    12 reports received today

    Last: 2 minutes ago

    Email Attachments

    8 reports processed today

    [email protected]

    ePCR Integration

    247 reports auto-imported

    ESO Integration Active

    Manual Upload

    3 reports uploaded today

    Drag & drop enabled

    Processing Queue

    Real-time extraction

    Report #4521 - Cardiac Arrest

    Extracting data... 45% complete

    Processing

    Report #4522 - MVA

    Queued - Est. 30 seconds

    Waiting

    Report #4523 - Transfer

    Queued - Est. 1 minute

    Waiting
    Data Extraction Accuracy100%

    Complete accuracy on all field types • Handwritten notes • Scanned forms • Digital reports

  • Each report undergoes comprehensive analysis against your configured rules. AI examines field completeness, logical consistency, clinical appropriateness, and billing requirements. Cross-references CAD data, validates against protocols, and identifies unusual patterns.

    AI Analysis Engine

    Report: #4521 - Cardiac Arrest
    Multi-Layer Analysis in Progress87% Complete
    Compliance Validation
    Complete
    NEMSIS 3.5 fields: 142/142 complete
    State requirements: All met
    Medicare signature requirement needs attention
    Clinical Logic Analysis
    Issues Found

    Medication-Allergy Conflict

    Aspirin administered but allergy to NSAIDs documented

    Timeline Inconsistency

    CPR duration (45 min) exceeds scene time (30 min)

    Revenue Optimization
    Analyzing...

    Checking for billable procedures...

    Validating medical necessity...

    Cross-referencing payer requirements...

    Cross-Field Validation
    Pending

    Waiting to analyze...

    Analysis ConfigurationAgency Custom
    Rules Applied: 523
    Custom Rules: 47
    Protocol Version: 2024.1
    AI Model: Advanced

  • Critical issues rise to the top—high-risk refusals, missing signatures, billing problems. Each finding includes severity level, specific location in the report, and suggested remediation. Adaptive learning reduces false positives based on your feedback.

    QA/QI Alert Dashboard

    Last 24 Hours: 247 Reports Analyzed

    3

    Critical

    12

    High

    28

    Medium

    45

    Low

    Missing Refusal Signature

    Report #4498 - High-risk refusal

    CRITICAL

    Issue: Patient refused transport after syncopal episode but signature section blank

    Risk: Legal liability - no proof of informed refusal

    Action: Contact crew immediately for signature addendum

    Undocumented ALS Procedures

    Report #4512 - Cardiac Arrest

    HIGH

    Issue: IV and intubation supplies used but procedures not documented

    Impact: $1,200 potential lost revenue for unbilled ALS procedures

    Action: Follow up with crew for procedure documentation

    Incomplete Narrative

    Report #4515 - BLS Transfer

    MEDIUM

    Issue: Medical necessity not clearly documented for non-emergency transport

    Impact: Potential Medicare denial without proper justification

    AI Learning Active

    System has adapted to your agency's patterns - 23% fewer false positives this month

  • Track resolution of identified issues, monitor provider improvement, and measure compliance trends. Export findings for billing teams, generate training reports for supervisors, and demonstrate compliance for accreditation.

    QA/QI Analytics Dashboard

    Compliance Rate

    94.2%

    Avg Resolution Time

    2.4h

    Revenue Recovered

    $47.2K

    Reports Reviewed

    3,842

    Provider Documentation Quality

    JD

    John Davis - Paramedic

    142 reports

    98.2%

    Excellent

    SM

    Sarah Miller - EMT

    89 reports

    82.4%

    Needs Training

    RJ

    Robert Johnson - Paramedic

    167 reports

    95.7%

    Good

    Top Documentation Issues This Month

    Missing Medical Necessity127 occurrences
    Incomplete Vital Signs84 occurrences
    Timeline Discrepancies52 occurrences
    AI-Generated Recommendations
    • • Schedule medical necessity documentation training for BLS crews
    • • Implement vital signs checklist reminder in ePCR system
    • • Review CAD integration to reduce timeline entry errors
    • • Focus QI efforts on Sarah Miller - 3 critical issues this month

Why Manual Review Can't Compete

Human reviewers catch 60-70% of issues. AI catches 95%+

  • Pattern Recognition at Scale - Identifies subtle fraud patterns and system abuse across thousands of reports that humans would never connect.

  • Real-Time Processing - Reviews reports within minutes of submission, enabling immediate correction and reducing payment delays.

  • Consistent Standards - Never gets tired, never misses criteria, applies the same rigorous standards to report #10,000 as report #1.

  • Continuous Improvement - Learns from every reviewed report, adapts to new patterns, and evolves with your changing requirements.

Calculate Your QA/QI ROI

Measurable Impact Across Every Metric

Agencies using AI-powered QA/QI see dramatic improvements in compliance, revenue, and efficiency

100%
Report Coverage

Every single report reviewed, not just random samples

40%
More Issues Found

Compared to manual review of the same reports

23%
Revenue Recovery

Average increase from caught billing opportunities

6x
Faster Review

Complete analysis in minutes instead of hours

Built for How Modern EMS Operates

Your QA/QI process shouldn't be limited by outdated technology or manual workflows. Whether you're a small rural service reviewing dozens of reports weekly or a metropolitan system processing thousands daily, our platform scales to meet your needs.

Choose from our library of 500+ prebuilt rules covering everything from NEMSIS compliance to specific payer requirements. Add unlimited custom rules for your regional protocols, internal standards, or special initiatives. Apply different rule sets to different call types, ensuring relevant review without unnecessary alerts.

QA/QI RESOURCES

Learn How Leading Agencies Transform Their Quality Programs

Case studies, best practices, and implementation guides

  • The Hidden Costs of Documentation in EMS

    The Hidden Costs of Documentation in EMS

    Discover five ways outdated documentation practices harm your organization and what forward-thinking agencies are doing to fight back.

    Read more
  • CareSwift: Real-World Impact for Enterprise EMS Operators

    CareSwift: Real-World Impact for Enterprise EMS Operators

    Discover how CareSwift has achieved organic growth to 30% of NYC's hospital-based EMT workforce, delivering 50-90% documentation time reduction and enterprise-scale operational benefits.

    Read more
  • CareSwift Unveils V3 Platform with Real-Time QA/QI

    CareSwift Unveils V3 Platform with Real-Time QA/QI

    CareSwift unveils its groundbreaking V3 documentation solution featuring real-time voice interaction, dynamic prompting, and pre-submission QA/QI validation for ePCR systems.

    Read more

Stop Sampling.
Start Reviewing
Everything.

See how AI-powered QA/QI can transform your quality program, recover lost revenue, and ensure compliance across 100% of your reports. Schedule a demo with your own data.

Request Your QA/QI Analysis

Experience how CareSwift can transform your EMS documentation and revenue recovery with our AI-powered platform.

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