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

Where the MDS and the chart stop matching

A PDPM audit and a documentation audit are looking for the same fracture: the assessment, the clinical record, and the claim are not one story. RevOptix1 is SNF chart-review software for that comparison. It does not replace the EHR and it does not submit a claim.

Two directions, one problem

• The note supports a diagnosis or an NTA comorbidity, and MDS Section I does not list it.
• Section I lists an item, and the history and physical, the diagnosis list, or the nursing record does not support it.

Either direction can matter in a MAC review, an ADR, or a survey, because the reviewer can open the same chart you can. The published sample is the first direction: an NTA comorbidity in the physician history and physical, absent from the MDS.

What a useful finding contains

A finding that a building can work with names the stay, the source document, the date, the MDS item, and the action on the chart. “Reconcile Section I to the history and physical” is an action. A percentage of revenue with no stay behind it is not. RevOptix1 does not publish a facility-wide recovery rate. The revenue worksheet multiplies census figures you type yourself and labels the result as arithmetic, not a finding.

Keep reading on this domain

MDS audit software, Section GG, PDPM audit software, and how to prepare an ADR response.

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