Comparing Top Chart Review Solutions for Healthcare in 2026

Compliance challenges are growing for healthcare providers in 2026. Clinician burnout and turnover remain near record highs, increasing organizational risk as chart review responsibilities more often fall to overextended or less experienced staff.

Meanwhile, external scrutiny of documentation is ramping up steadily, as regulators take a closer look at documentation through more frequent MAC and RAC reviews. Commercial payors are also more frequently and more intensely auditing session notes and patient records. These audits are moving beyond check-the-box reviews to search for harder to spot errors, such as notes containing vague language.

In this landscape, reliable chart review has moved from being a nice to have to being table stakes healthcare infrastructure. 

Chart review is the systematic evaluation of medical records to ensure documentation accuracy, compliance with regulatory and payor requirements, and valid coding and billing. When done correctly, systematic chart review reduces audit risk, minimizes revenue leak, improves clinical quality and can even lower clinicians’ administrative burden (more on that later).

As chief compliance and quality assurance officers hunt for chart review tools that support their organizations’ QA goals, they’ll want solutions that are, at minimum, accurate, efficient and reliable. However, the best solutions will go beyond the basics and help guide treatment plans and even provider education. 

This guide is designed to help your team navigate the options available for chart review in 2026, to help you confidently select the tool that best fits your organization’s unique needs. 

This guide explains:

• What chart review is.
• Why compliance matters more than ever.
• What features to look for when choosing chart review solutions.
• The difference between leading chart review solutions.
• Our final, best recommendations — tailored to your needs.

Why Reliable Chart Review Matters More Than Ever

Healthcare documentation requirements continue to grow, even as EHR usability challenges remain unresolved. Research consistently shows that physicians spend almost twice as much time working in electronic health records as they do with patients, fueling burnout and operational inefficiencies.

At the same time, payors are expanding audits related to medical necessity, coding accuracy, quality measures (such as HEDIS) and behavioral health documentation.

Investing in chart review can help your team:

• Reduce clinician administrative burden, by minimizing the amount of time and energy spent on documentation rework. 
• Improve audit outcomes and protect revenue from insurer clawbacks. 
• Ensure treatment plans and medication management are justified and patients are tracking toward behavioral health treatment goals.
• Improve revenue cycle management and allow faster claim resolution.
• Offer better visibility into compliance risk via audit trails and accuracy metrics.

How We Evaluated Solutions

When we compared chart review solutions head-to-head, we searched first for tools that were both reliable and accurate — because cost savings and efficiency gains only matter if the chart review results are at least as accurate as the coding done by your own team.

Vendors received bonus points if they leveraged technology and were well poised to evolve with providers' business needs and the changing technological landscape. Tools should remain viable solutions as healthcare practices expand and as technology becomes more sophisticated.

Our ideal solutions offer:

• EHR integration now and in the future. 
• Configurable workflows by provider specialty and payer.
• Audit trails that show their work. Audit trails are chronological records of all actions taken during a chart review, helping to ensure transparency and regulatory defensibility of reviews.
• Clinician adjudication for edge cases, so that when a chart doesn’t clearly meet (or fail) defined criteria, a trained compliance expert has the final say.
• Regularly updated accuracy reporting, including sensitivity and specificity analytics.

Brellium 

Brellium uses AI to review every note against your strictest payor’s latest requirements.Brellium represents a newer category platforms designed to automate chart review while preserving clinical rigor.

At its core, Brellium is a comprehensive compliance platform that uses technology to help clinical teams streamline operations and enhance care delivery. Brellium differentiates itself from competitors in the space by employing a team of compliance experts to advise on new regulations, payor rules and documentation nuance. 

The team has deeper knowledge of compliance than any of the AI-powered startups vying for providers’ attention. Brellium currently audits more than 1 million records each month and works with providers across 50 states. 

They’re using that knowledge to create a flexible platform that can adapt to providers’ specific workflows and payor requirements.

When compared to competitors and traditional EHR offerings, Brellium distinguishes itself through its modern, intuitive interface and unique reporting features. Not only does Brellium audit charts, Brellium offers reports that can help clinics and individual providers reduce their risk over time. Reports highlight where teams are performing well and where they may need further education. 

The platform bridges the gap between heavyweight enterprise health IT systems that require extensive implementation resources and lightweight tools that lack the depth needed for comprehensive practice management.

Key differentiators include:

• Direct EHR integration to eliminate duplicate data entry
• AI-driven automation paired with clinician oversight
• Real-time accuracy reporting, including sensitivity and specificity
• Fast turnaround times without sacrificing compliance rigor
• Purpose-built workflows, with offerings for behavioral health and broader healthcare providers

Cons:

• Some extremely small providers may not process enough notes per month to see a ROI of working with Brellium.
• Brellium currently only serves U.S. healthcare organizations.
• Brellium currently takes several weeks to implement.

EHR-Integrated Chart Review Vendors

For many organizations, the most important factor in selecting a chart review provider is how deeply the solution integrates with their EHR. Poor integration increases click burden, slows reviews, and frustrates clinicians — creating friction in the review process.

Leading EHR-integrated vendors typically support platforms such as Epic, Cerner, and NextGen, embedding review tools directly into clinical workflows.

Pros

• Streamlined workflows and reduced rework
• Native access to structured and unstructured data
• Improved clinician adoption
• Significant, deep expertise in mapping to one EHR

Cons

• Specialty-specific customization may be limited
• Some tools prioritize check-the-box compliance that’s easily documented over compliance depth
• Implementation timelines can be long
• Snags if provider migrates EHR

Clinical Documentation Improvement (CDI) and Outsourced Review Firms

Traditional Clinical Documentation Improvement (CDI) firms and outsourced chart review providers remain common. These vendors rely on trained clinicians and coders to conduct retrospective, concurrent, or prospective reviews.

CDI firms are often the first solution providers turn to when considering chart review solutions — especially because they can  be outsourced offshore to cheaper labor sources. This solution is a great option to help plug seasonal, short-term holes in your compliance staff. 

However, relying on outsourced review is not a long term solution for most providers, because it still relies on outdated methodology. Adding outsourced staff increases operational risk by expanding the network of people with access to PHI, but you lose the advantage of your coders having rich clinical context attached to charts. 

It’s typically a lose-lose — the consultants are worse at catching errors than automated solutions and they don’t know enough about your organization to weigh in on edge cases.

Advantages

• Advanced training in compliance
• Useful for short-term or surge needs

Tradeoffs

• Longer onboarding and ramp-up to understand your organization
• Higher variable costs at scale
• Limited automation and real-time feedback

Our Final Thoughts

There are considerable benefits to partnering with a trusted chart review partner. Organizations that invest in high-quality chart review partnerships consistently report:

• Reduced clinician administrative burden
• Fewer payer denials and clawbacks
• Improved audit readiness
• Better patient safety outcomes
• More efficient revenue cycle management

As regulatory complexity increases, reliability is no longer optional — it is foundational.

After reviewing the products available, Brellium outperforms the market by:

• Offering a scalable solution that draws insights from 12 million+ audits performed. The tool is built for your audit needs now and in the future.
• Seamless EHR integration – Brellium integrates directly with leading EHRs, minimizing workflow disruption and allowing teams to review charts without exporting data or managing multiple systems.
• Audit-ready, explainable results – Unlike black-box models, Brellium provides clear rationale behind findings, helping organizations defend decisions during audits and build clinician trust.
• Scales without adding PHI risk – Brellium reviews charts automatically and consistently, reducing reliance on large outsourced teams and limiting unnecessary third-party access to sensitive patient data.