RevOptix1 is the software. PDPM Audit Optimization Group is the expert team. This page is educational. It is not legal, coding, or billing advice.

Audit-readiness checklist before MAC, ADR, or survey

Use this list while the window is still yours: before the Medicare Administrative Contractor review, before the additional documentation request is due, or before surveyors ask for the record. It is a working list, not a guarantee that a review will go a certain way.

The list

1. Name the stay, the assessment reference date, and the HIPPS that was billed.
2. Export the chart you already have: history and physical, diagnosis list, orders, therapy, and nursing notes. PDF, CCD, HL7, and FHIR R4 are the export types RevOptix1 reads. See which EHR exports the review accepts.
3. Read MDS Section I next to those notes. Mark comorbidities in the record that are missing from the MDS, and MDS items the note does not support.
4. Do the same for the NTA-related diagnoses you are relying on. The sample finding is an NTA comorbidity in the history and physical that never reached the MDS.
5. If Section GG, nursing, or therapy minutes are in dispute, open those source notes before you write the explanation. Section GG notes.
6. Assign a person to the chart action: correct the assessment, coach the documentation, or explain why the record already supports the item.
7. If software will touch a resident chart, sign the Business Associate Agreement first. Upload stays closed until the BAA, payment, and onboarding are done. Read how encryption, sign-in, and the BAA work.
8. Decide whether you need a person on the file. Expert retainers from PDPM Audit Optimization Group are separate from the $550 three-month software pilot. Compare software prices by bed count.

Then read the ADR guide or watch a synthetic chart go through the sample review.

Book a 15-minute demo · Read the anonymized sample report · Back to the homepage