Identity and service consistency
- Correct beneficiary and authorized identifiers
- Order, service, code, laterality, setting, and date align
- Ordering and furnishing parties are clear
Evidence quality
WISeR documentation readiness
Build a packet that is relevant, consistent, legible, and traceable to the source record—without manufacturing support.
CMS requirements and assigned official participant instructions control. WISeRly is independent, not CMS-affiliated or endorsed, not an official WISeR participant, does not issue determinations, and does not guarantee authorization or payment.
Pre-submission checklist
Clinical relevance
- Records address current service-specific criteria
- History, findings, tests, and treatment response are internally consistent
- Time periods and sequence are understandable
Document integrity
- Required signatures, credentials, and dates are present
- Pages are readable and correctly ordered
- Source documents and revisions remain traceable
Gap handling
- Missing and contradictory facts are flagged
- No facts are invented or silently changed
- Qualified staff resolve issues through approved processes
Readiness is not a prediction
A packet can meet an internal completeness checklist and still receive non-affirmation or other official action. Conversely, a software warning does not establish ineligibility. Preserve this distinction in dashboards and conversations.
Human review: AI-assisted review can identify possible gaps, duplicates, or inconsistencies. It does not establish medical necessity and must not be represented as a human clinical determination. WISeRly provides no official result.
Official source check
CMS WISeR model page · Provider and Supplier Guide v7.0, updated July 24, 2026
Synthetic/no-PHI boundary: public WISeRly demos do not accept patient records or PHI. Use fictional documents and identifiers only.