Clinical documentation queries
How do we send a compliant clinical documentation query to the physician, capture the answer, and update the chart before the claim is billed?
Make the query a compliant question with a clock that holds the claim. When coding or clinical documentation integrity needs clarification (a diagnosis without specificity, a condition documented by one clinician and not the attending, a clinical indicator without a diagnosis, a procedure without the detail the code needs), Callvu classifies the query type and the compliant format (an open question or a multiple choice with the clinically reasonable options including other and unable to determine, the clinical indicators cited, no leading toward a code or a reimbursement), sends it to the right physician on their phone with the chart context, chases on the clock the policy sets with the claim held, captures the answer as an addendum the physician authenticates, checks that the answer is a documentation statement and not a code, routes a non-response or a disagreement to the physician advisor in the Decision Desk, and writes the addendum to the EHR and the query to the record so coding completes and the claim releases.
In scopeComplex: multi-party handoffsCallvu moves: classify, chase and verify, write back
Last updated November 7, 2026.
The problem today
The query sat in the physician's inbox for eleven days while the claim aged, and the answer when it came was a code, not a diagnosis.
Between the chart and the claim is a question only the physician can answer: was the sepsis present, which type of heart failure, was the condition present on admission. The query is a message in an inbox the physician checks weekly; the claim waits; the answer is sometimes 'use 428.0', which the compliance guidance says cannot be used. The discharged-not-final-billed days pile up on documentation.
A compliant query is a specific form: it cites the clinical indicators, asks an open or a properly constructed multiple-choice question with the reasonable options, never leads toward a diagnosis for reimbursement, and the answer becomes an authenticated addendum in the record. The timing is the policy's; the claim is held until the answer; the query itself is retained as part of the record or the business record as the policy elects. The physician will answer a question on their phone with the chart snippet in minutes.
A query the physician can answer in a tap is a claim billed this week.
How it runs
From the requestto the system of record.
A coder or a clinical documentation specialist identifies a documentation gap on an encounter before billing (or a concurrent review does during the stay). Callvu opens the query with the encounter and the indicators.
- Coder or clinical documentation specialist
- Raises the query with the indicators and reviews the answer.
- Physician
- Answers the query on their phone and authenticates the addendum.
- Physician advisor
- Decides non-responses and disagreements in the Decision Desk.
- Callvu
- Classifies, builds the compliant query, sends, chases, captures, checks, routes and writes.
Classify and build the query
The gap is classified (specificity, clinical validation, conflicting documentation, present on admission, a procedure detail, a query for a condition suggested by indicators) and the compliant format is applied: the clinical indicators from the chart are cited, the question is open or multiple choice with all clinically reasonable options plus other and unable to determine, the query is addressed to the right physician (the attending or the documenting clinician), and nothing in it references the code, the reimbursement or the expected answer.
Send and chase
The query goes to the physician on their phone with the chart context (the indicators, the relevant notes and results) and the answer options; the chase runs on the policy's clock with reminders and an escalation to the department lead, and the claim is held in the billing system until the query closes.
Chase and verify the answer
The physician answers on the secure screen and the answer is captured as an addendum to the record that the physician authenticates; the answer is checked: it is a clinical statement rather than a code, it addresses the question, and a disagreement or a non-response past the escalation is routed to the physician advisor in the Decision Desk with the query and only the allowed outcomes (a second query, a peer discussion, code as documented, or escalate under the policy).
Write back
The authenticated addendum is written to the EHR on the encounter, the query and its answer are retained as the policy elects (part of the record or the business record), coding completes with the documentation as it now stands, the claim is released, and the query is logged by type and physician for the documentation improvement report.
Where it ends: The physician answered a compliant question on their phone, the answer became an authenticated addendum in the EHR, the claim was held only as long as the answer took, and the record shows the query, the indicators and the answer. The Decision Trace shows the query type, the compliant format and any advisor decision; the Audit Trace shows the send, the chases, the answer and the write with time.
Runtime enforcement
What is enforcedwhile the work runs.
The regulations preloaded in Callvu Studio and the bank's own policies, applied as steps that run, not lines in a binder. A step that breaks a rule does not run, so a completed run was compliant.
The handoff
Between the front doorand the back office.
The front door
The physician on their phone with the chart context; the coder raises the query from the encounter.
The back office
The physician advisor decides only non-responses and disagreements; coding completes from the addendum.
The Decision Desk
- A non-response past the escalation, a disagreement or an answer that is not a clinical statement goes to the physician advisor in the Decision Desk with the query and only a second query, a peer discussion, code as documented, or escalate under the policy.
Proof
In scope.Proof at scale, not one process at a time.
The kind of process Callvu runs in production for customers in this industry. Ask for a reference on this exact process. The results below are the industry's published proof; each claim code links to its record on agents.callvu.com.
23 hospitals in the Ministry of Health network run on Callvu.
Across Callvu customers
More than 1,000 processes are live across Callvu customers.
Across Callvu customers
Questions
What buyers ask next,answered plainly.
What makes a query compliant?
It cites the clinical indicators, asks an open question or a multiple choice with all clinically reasonable options including other and unable to determine, and never references the code, the reimbursement or the expected answer; the process enforces the format.
How does the physician answer?
On their phone, with the chart context, and the answer becomes an addendum they authenticate in the EHR; a reply that is only a code is not accepted.
What happens to the claim?
It is held in the billing system until the query closes, with the chase and the escalation on the policy's clock, then released when coding completes.
Related processes
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