Stronger visit notes.
Practical clinician training.
Use the Skilled Visit Note Tool to organize visit details and spot documentation gaps, and/or build your skills with the AVHCS Clinician Academy.
Prices shown plus applicable tax.
Skilled Visit Note Tool
Use Analyze QA to flag missing or vague details and organize visit information into editable draft language.
- Strengthen skilled documentation
- Improve CMS skilled documentation compliance
- Analyze QA flags missing or vague details
- Visit information organized into editable drafts you review
Do not enter PHI
Clinicians must not enter protected health information, such as patient names, dates of birth, MRNs, or addresses.
Drafts are for clinician review and editing only. They do not determine Medicare eligibility or guarantee coverage or compliance.
$25 per clinician per month for standalone access, plus applicable tax
Subscribe · $25/monthAVHCS Clinician Academy
Clinician-focused education with the Skilled Visit Note Tool included.
- Skilled Visit Note Tool included
- RN-led, self-paced education
- Skilled Nursing Documentation Competency available now
- More competency modules coming soon
EQUIP™ Framework
Strong Documentation; Clear Skilled Care; and Confident Clinicians
$50 per user per month, plus applicable tax
Subscribe · $50/monthAgency subscriptions are available. Contact AVHCS for agency pricing.
AVHCS Clinician Academy Modules
- Skilled Nursing Documentation Competency
Here's a brief preview of upcoming Academy modules. This list is not all-inclusive; additional topics and competencies are in development.
- M1860 Ambulation/Locomotion Coding Competencycms.gov
- M1850 Transfer Ability Coding Competencycms.gov
- Building a Supportive Discharge Summary
- M2020/M2030 Medication Management Competency
- BIMS Interview Competency
Core Service Delivery
Comprehensive pre-bill QA covering every critical documentation touchpoint.
Agency QA Services
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.
QA Services
RN-led visit note QA, pre-claim review services, and expert consulting powered by the EQUIP™ Framework — from documentation quality oversight to QA program design, pre-billing chart audits, and regulatory readiness.
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
- Pre-Claim Review Services
- 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
Exclusive Benefit: Free AVHCS Clinician Academy Access included
$45
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.
Exclusive: Free AVHCS Clinician Academy Access
Discharge 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.
Exclusive: Free AVHCS Clinician Academy Access
Transfer 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.
Exclusive: Free AVHCS Clinician Academy Access
ADR Clinical Defense Review™
RN-led clinical review, ADR appeal services, 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 →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.
Clinical Precision Meets
Revenue Defense
A 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.
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