Stop Denials
Before They Start
The EQUIP™ Pre-Bill Clinical Defense Framework catches documentation deficiencies before claims submission — protecting your revenue at the point of care.
Clinical Precision Meets
Revenue Defense
A HIPAA-compliant, AI-enabled pre-bill clinical defense system designed to identify risk before submission, standardize documentation quality, and protect agency revenue at the point of care.
Pre-Bill QA. Post-Denial Defense. Full-Cycle Clinical Protection.
Built on CMS Conditions of Participation, surveyor methodology, and payer denial logic — EQUIP™ ensures every chart is complete, clinically supported, and defensible at every stage: before billing and when an ADR demands a response.
Expertise
RN-led, dual-credentialed clinical reviewers
Quality
Structured deficiency identification with audit triggers
Utilization
Optimized documentation workflows in your EMR
Improvement
Clinician education feedback loop for lasting change
Profitability
Revenue protection through pre-bill risk elimination
Structured Deficiency Identification
Line-level gaps with high-risk audit triggers flagged in every review.
Actionable Correction Guidance
Clear clinician instructions with suggested language — not vague feedback.
Clinician Feedback Loop
Simple, structured communication for rapid correction and education.
Compliance & Revenue Protection
Pre-bill risk identification aligned with ADR/UPIC standards.
Core Service Delivery
Comprehensive pre-bill QA covering every critical documentation touchpoint.
Skilled Nursing (SN) Visit Note Reviews
Complete assessment of SN documentation for medical necessity, skilled need, homebound status, and objective clinical data.
Therapy (PT / OT / ST) Visit Note Reviews
Validation of therapy documentation for skilled interventions, functional progress, and treatment plan alignment.
OASIS-E2 Review & Accuracy
Comprehensive OASIS assessment validation ensuring clinical consistency, accurate scoring, and PDGM alignment.
ICD-10 Coding Validation
Diagnosis-to-care linkage validation, PDGM-allowable code verification, and primary diagnosis sequencing review.
Medical Necessity & Skilled Need Verification
Ensures every visit documents clear skilled need, measurable goals, and clinical rationale supporting continued care.
Objective Clinical Data Enforcement
Ensures documentation includes measurable vitals, assessment findings, and clinical data — not cloned or template language.
ADR Clinical Defense Review™
Comprehensive RN-led clinical review and appeal support that evaluates medical necessity, skilled services, homebound status, and documentation defensibility to strengthen your Medicare ADR response.
$125
Per Review Hour · 1 Hr Minimum
Performance & Capacity
10
Notes per QA hour
24–48hr
Completion timeframe
Priority
QA processing available
Scalable
Aligned with agency volume
Your Long-Term Compliance &
Revenue Integrity Partner
We're not a coding factory or offshore volume processor. Avory is an RN-led, U.S.-based QA partner that embeds directly into your EMR workflows — catching deficiencies before they become denials.
100% U.S.-Based Team
Every reviewer is U.S.-based — no offshore processing, no handoffs across time zones.
Pre-Bill QA & Post-Denial Defense
We strengthen documentation before billing and stand behind agencies when ADRs arrive — covering the full clinical compliance lifecycle.
Dual HCS-O & HCS-D Credentials
Our team holds both OASIS and diagnosis coding certifications.
Flexible Engagement, Built for Partnership
We structure engagements around your agency's needs — not rigid terms. Our goal is to become a trusted, long-term extension of your clinical team.
Scalable to Your Census
From 50 to 200+ charts per month. We grow with you.
Measurable Impact in the First 6 Months
Real numbers from real agencies. EQUIP™ delivers audit-defensible documentation and protected revenue.
$50K–$250K+
Revenue Protected
Average in first 6 months
25–50%
Fewer ADR Denials
Within 60–120 days
10–25%
Less Revenue Leakage
Preventable losses eliminated
≥95%
On-Time SLA
Consistent delivery
Common Denial Patterns We Eliminate
These are the documentation gaps that trigger ADR/UPIC denials — and exactly what EQUIP™ catches before billing.
- ✕Unsupported medical necessity
- ✕Unsubstantiated homebound status
- ✕Lack of documented skilled need
- ✕OASIS inconsistencies with clinical narrative
- ✕Diagnosis/PDGM misalignment
- ✕Plan of care disconnects
- ✕Missing objective clinical data
- ✕Cloned or template documentation
Simple, Transparent Pricing
No hidden fees. No long-term contracts. Choose the service level that fits your agency.
QA Services
RN-led visit note QA and expert consulting powered by the EQUIP™ Framework — from documentation quality oversight to QA program design and regulatory readiness.
- SN & Therapy Visit Note Reviews
- Structured deficiency identification
- Actionable correction guidance
- Clinician feedback loop
- Compliance & audit-readiness oversight
- QA program design & implementation
- Compliance strategy & risk assessment
- Workflow optimization
- Regulatory readiness planning
- Staff training & education
- Documentation benchmarking
- Custom KPI development
$85
per QA Hour
Full Chart Reviews + POC
OASIS-E2 Review, ICD-10 Coding, and Plan of Care Review — all included in every chart.
SOC, ROC, Recertification & SCIC OASIS QA Review
Build a Strong Foundation. Validate Continued Eligibility. Protect Reimbursement.
$65
per chart
RN-led review covering admissions, resumptions, recertifications, and significant changes in condition — ensuring every assessment is accurate, defensible, and aligned with CMS requirements before billing.
- OASIS coding accuracy validation
- ICD-10 diagnosis sequencing review
- Homebound status verification
- Medical necessity & skilled need validation
- PDGM reimbursement optimization
- Recertification eligibility assessment
- Significant Change in Condition (SCIC) validation
- Plan of Care consistency & alignment
- Functional status & clinical progression review
- Medication reconciliation review
- Documentation defensibility assessment
- CMS compliance & Conditions of Participation review
- Actionable QA feedback & correction recommendations
Protect reimbursement and ensure every assessment starts — and continues — with a clinically defensible record.
Get StartedDischarge OASIS QA Review
Ensure Accurate Outcomes. Protect Reimbursement. Strengthen Compliance.
$45
per chart
RN-led validation that your final assessment accurately reflects the patient's clinical status, supports appropriate discharge, and aligns with Medicare documentation requirements.
- OASIS coding accuracy validation
- Functional outcome consistency review
- Goal achievement verification
- Skilled need & discharge justification
- Documentation defensibility assessment
- Quality measure & Star Rating protection
- CMS compliance review
- Actionable QA feedback & correction recommendations
Close every episode with confidence.
Get StartedTransfer OASIS QA Review
Ensure Accurate Transfer Documentation. Protect Compliance.
$20
per chart
RN-led review confirming transfer assessments are accurately completed, properly coded, and aligned with CMS documentation requirements.
- OASIS transfer item accuracy review
- Transfer reason & destination validation
- Documentation completeness check
- CMS compliance review
- Actionable QA feedback & correction recommendations
Accurate transfers protect quality measures and Star Ratings.
Get StartedADR Clinical Defense Review™
RN-led clinical review and appeal support for Medicare ADR responses. Includes a complete medical record review, documentation gap analysis, CMS coverage assessment, and a detailed written findings report with your Overall Clinical Defensibility Score.
View full service details →$125
per Review Hour
1 hour minimum charge
Flexible engagements structured around your agency's needs. All services include a clinician feedback loop.
Go Live in 7–14 Days
Minimal disruption. Immediate visibility into documentation risks. Urgent backlogs in as few as 3–5 days.
Days 1–3
Discovery
Workflow mapping, EMR access setup, volume assessment, and key contact alignment.
Days 3–7
Configuration
EQUIP™ tool configuration, QA template setup, and review protocol calibration.
Days 5–10
Live Pilot
Initial chart reviews with feedback loop. Calibrate deficiency thresholds and clinician communication.
Days 10–14
Full Integration
Full-volume QA embedded in your EMR. Ongoing optimization and leadership reporting.
The Weekly Walkthrough
A one-page, scannable home health documentation + compliance email — delivered every Monday. Built to reduce denial risk, tighten OASIS accuracy, and reinforce audit-defensible habits.
- Big 3 Reminders (what to double-check)
- Quick Compliance Hits (fast + practical)
- OASIS-E2 accuracy tips
- QA Spotlight: Stop/Start + red flags
Get the next issue
No spam — unsubscribe anytime.
Ready to Protect Your Revenue?
Schedule a free QA consultation. We'll review your current documentation workflow and show you exactly where EQUIP™ can reduce risk and protect reimbursement.
Call or Text
336-269-5097Christina Koch, RN-BSN, HCS-O, HCS-D
Owner / Manager
10+ Years Healthcare Quality Audit Experience