Charta Health raises $55 million to expand AI chart review

By Sophie Lindqvist

Charta Health said it raised $55 million in a Series B on November 10, 2026, led by Insight Partners, to expand its AI-assisted medical chart review.

The round also included QuantumLight and returning investors Madrona, Bain Capital Ventures and South Park Commons, according to Charta Health.

Insight Partners co-founder and managing director Jeff Horing tied the investment to a simple idea: “As payers and providers both adopt AI, we believe the opportunity lies in getting the underlying record, or the ‘ground truth,’ right before a claim is submitted,” he said.

His framing puts the clinical record at the center of billing. Charta is trying to make one evidence review useful to a provider preparing a claim and a payer checking the same record.

What does the $55 million round fund?

Charta Health said it will put the capital toward three goals:

• Further AI development for provider customers.
• Entry into additional medical specialties.
• Establishing one trusted interpretation of a chart before billing.

Alongside the financing, Charta Health broadened Charta for Payers, a suite initially aimed at Medicare Advantage and Affordable Care Act Marketplace plans.

That move places Charta on both sides of payment. Its shared premise is that providers and payers need the same clinical evidence before a claim enters the billing process.

Takeaway: The financing turns chart review into a shared layer for provider billing and payer coding.

How does pre-billing chart review work?

Charta Health said its provider software reviews every chart before billing against coding guidelines, payer rules and each customer’s clinical protocols. Findings appear for human approval inside the electronic health record, leaving staff to validate the issues flagged by the system.

The software applies large language models to unstructured material such as free-text notes, scanned orders, laboratory results and images. According to Charta, it establishes what care was delivered and whether the documentation supports the billing, moving accuracy checks ahead of denials and appeals that can follow a claim.

Charta Health said compliance and medical leaders can examine documentation deficiencies, error patterns and provider performance across patient encounters. The company presents this as more than a claim-by-claim check, though staff still validate every flagged issue.

American Family Care, Grow Therapy and Pediatric Associates Family of Companies are among the healthcare enterprises using the technology, Charta said. The company reports consistent double-digit reductions in denial rates for fee-for-service billing.

Takeaway: Charta moves the first coding check into the clinical workflow, but a person still signs off on every flagged issue.

What does Charta for Payers do?

Charta Health said Charta for Payers looks for documented conditions that were not coded and for coded diagnoses that lack support in the chart. It checks coding in both directions, because a record can contain care the plan did not code while a claim can contain a diagnosis the record does not support.

The suite spans six product areas:

• Retrospective diagnosis coding.
• Automated second-pass coding.
• A smart coding workspace.
• Prospective risk-adjustment intelligence.
• Diagnosis validation and audit workflow.
• Quality care-gap detection.

Charta Health said it designed the suite with one of the nation’s largest health insurers, which the company did not name.

According to Charta, the platform extracts structured clinical and encounter intelligence from records plans already retrieve. It reuses that evidence for retrospective coding, second-pass quality assurance, audit work and prospective workflows.

Takeaway: The platform reuses clinical evidence across coding, audit and risk work rather than treating each payer task as a separate records project.

How do the AI coding tools work?

Charta Health said its automated second-pass product applies AI to 100% of coded charts. The smart coding workspace presents supporting evidence, citations, and additions and deletions for validation in one review.

For retrospective risk adjustment, AI presents clinical evidence to human coders, according to Charta. Coders use customer-specific guidelines to validate additional diagnoses and flag unsupported codes for deletion.

Charta’s Smart Scan product pre-screens the chart population to identify records with enough potential value to warrant full review. The pre-screen directs attention toward records most likely to change, while final diagnosis decisions stay with the human team.

Takeaway: AI supplies and organizes evidence, while customer rules and human coders determine the final code changes.

What does Charta’s 98% accuracy figure mean?\n

Charta advertises 98% accuracy for diagnosis coding in this workflow, based on the combination of AI evidence recall and human validation.

The two headline coverage numbers describe different work. The 100% figure measures how many coded charts receive the automated second pass; the 98% figure measures accuracy after AI evidence retrieval and human validation.

AI evidence recall means the system surfaces clinical material relevant to a diagnosis. Human validation means coders judge that material against customer-specific guidelines. Charta therefore attributes the 98% result to the full workflow, not to an autonomous model acting alone.

Takeaway: Buyers should read 98% as Charta’s reported measure for an AI-plus-human workflow, not as proof of fully autonomous coding.

What did investors fund before?

Charta Health announced a $22 million Series A on July 22, 2025, led by Bain Capital Ventures. Madrona, SV Angel, Refract Ventures and South Park Commons participated in that earlier round, according to Charta Health. Charta said its total funding exceeded $30 million at the time.

Charta said its earlier announcement focused on automating provider chart review. The new financing pairs continued provider development with a broader payer product rollout.

That shift explains why Charta now describes one shared chart record as the central test of its model. Provider claims and payer audits can draw on the same evidence, but the company still depends on human coders and clinical reviewers.

Takeaway: The Series B expands a provider-focused product into a shared system for provider claims and payer audits.

What has to work next?

Charta’s expansion makes a shared chart record the central test of its model. The same evidence can help a provider submit a better-supported claim and a payer identify an unsupported diagnosis; the commercial challenge is making the review dependable enough for both sides while humans remain responsible for coding decisions.

The company plans to extend its provider software into more specialties and take Charta for Payers beyond its initial Medicare Advantage and Affordable Care Act Marketplace focus. The system must apply consistent review across different coding guidelines, payer rules and customer clinical protocols.

Charta reports consistent double-digit reductions in fee-for-service denial rates, 98% diagnosis-coding accuracy and 100% coverage of coded charts in its automated second pass. Its next proof point is whether it can preserve those reported outcomes as it adds specialties, workflows and payer customers.

Takeaway: Charta’s next test is operational consistency across added specialties and payer markets while preserving the denial, coverage and accuracy figures it reports.