OASIS and coding checks, built for your home health agency
Moative builds custom AI inside home health and hospice agencies. For coding and OASIS, our AI agents check every assessment and code before the claim; our experts set your rules.
Coding and OASIS work, in the order our study ranks it
- Assessment review and case-mix code validationIn the top three of 169 workflowsWorth it, ready now
- Assessment timepoint and submission managementIn the top ten of 169 workflowsWorth it, ready now
- Visit-count and low-utilization threshold monitoring per periodIn the top ten of 169 workflowsWorth it, ready now
- Hospice level-of-care and site codingIn the top 25 of 169 workflowsWorth it, ready now
- Diagnosis coding for the periodIn the top 25 of 169 workflowsWorth it, ready now
- Service intensity add-on determinationIn the top half of 169 workflowsWorth it, ready now
- Visit and service line codingIn the top half of 169 workflowsWorth it, ready now
- Documentation-to-payment consistency checkIn the top half of 169 workflows
- Documentation completeness checkIn the top half of 169 workflows
- Documentation gap escalation to the clinician, the clinical manager and the physicianIn the lower half of 169 workflows
Your cleanest coding month starts with the workflow that hurts most.
Talk to us about one workflow
Coding and OASIS errors get paid for twice
Before anything of ours runs, the coding and OASIS work in your agency leaks money in three ways.
Returned claims
An unacceptable principal diagnosis or mismatched scored item returns the claim unpaid.
Late assessments
Home health assessments must be submitted within 30 days of completion.
Missed thresholds
A period that falls under its visit threshold drops from case-mix to per-visit pay.
Assessment checks that stop the claim before it bounces
Each of these three workflows checks the assessment, its clock and its visit count before the claim goes out.
Catch the assessment that returns claims before it goes out
A coding vendor's two-day turnaround lets a scored item that disagrees with the visit narrative reach the claim. Our AI agents read both, flag the disagreement to the assessing clinician, and hold the case-mix code until cleared.
- Every assessment checked before the claim
- Inconsistencies routed to the clinician
- Case-mix code shown before the claim
Every assessment timepoint held to its window
Assessments submitted in batches surface late and rejected records at the payment penalty. A completed home health assessment carries a submission deadline; our AI agents track each timepoint and confirm acceptance before the claim.
- Every timepoint tracked per patient
- Acceptance confirmed before the claim
- Timeliness rate reported per branch
See the LUPA threshold coming while a visit can fix it
A period that drops to per-visit pay is found at billing, too late. LUPA thresholds are set per 30-day period by payment group; our AI agents compute the threshold, compare visits daily and alert the clinical manager.
- Threshold computed for every period
- Visit counts compared daily
- Alert reaches the clinical manager in time
Built inside your operation, one workflow at a time
Our experts pick your starting point from a ranked study of 169 home health and hospice workflows. Then three moves, in your order.
01What your agency brings
Your coding and billing staff, your EMR, and the outcome you want: claims that bounce, assessments that go late. Our experts work backwards from it with you.
02What our experts do
Our engineers sit with your billing team, observe the workflow before automating it, and fix its data. Rules are written where your coder can see them.
03What our AI agents do
Our AI agents run beside your EMR and payer portals, checking each assessment and claim, flagging what fails. Then our engineers move to the next workflow.
Where custom AI built inside your agency beats what you have now
Your agency compares us with the coding and billing setup it has. Here is the honest line on each alternative for this work: good at what, and where it stops.
Custom AI built inside your agency
Our engineers make the AI for your workflows, payer mix and systems, inside your operation. Your coder sees every rule; our experts set them and take the flags.
- Every assessment checked before the claim
- Rules your coder can see and change
- Your headcount stays off the bill
Billing and RCM software
Good at holding your coding and OASIS steps in one place. Its edits are usually standard, so payer quirks stay manual.*
Your EMR's billing module
Good at scoring the assessment inside its chart. It usually edits the standard path, so your payer-specific checks often ride on workarounds.*
An outsourced billing company
Good at taking the coding pile off your desk. Their coders follow their playbook; your assessments usually move to their queue.*
* Each description covers its category as commonly sold; vendors within it vary. Terms and coverage vary, so check the specifics of what you are offered before you decide.
Your EMR stays, your team decides, priced by workflow
How is this priced?
Pricing is a base fee plus an outcome-based component, determined by the workflows automated. Adding users costs nothing; adding workflows is what moves it.
Do we have to replace our EMR?
No. Our AI agents run beside your existing EMR, clearinghouse and payer portals, and your agency keeps its data. You do not replace your EMR to use them.
Who makes the clinical calls?
Your team does. Our AI agents check and flag; your staff review what the agents flag and decide. The software makes no clinical decisions.
What must our agency have ready?
A workflow that hurts and a person who knows it. Our experts observe the workflow before automating anything, so you bring the problem and we bring the engineers.
Your cleanest claim month starts with one workflow
Tell us the workflow that hurts most, coding or OASIS. Our experts walk your numbers with you and pick the first; our AI agents take it over.
Common questions
What does LUPA threshold mean?
The LUPA threshold is the minimum visits a 30-day period needs for the full rate; fewer visits pay per visit. It is set per payment group, at the 10th percentile or two visits.
When must OASIS transfer discharge forms be completed?
Home health assessments must be submitted within 30 days of completing the assessment. Our AI agents track every timepoint per patient and confirm acceptance before the claim.
What are the four levels of care in hospice?
The four levels are routine home care, continuous care, respite and general inpatient care. Continuous care requires a minimum of eight hours per day and must be predominantly nursing during a crisis.
What are the CMS billing guidelines for hospice services?
Hospice visit units are reported in 15-minute increments. The service intensity add-on covers nurse and social worker visits in the last seven days of life, capped at four hours per day.
What are the key items on a home health agency compliance checklist?
The key items are the encounter note elements, certification dates, the narrative, plan-of-care signatures, visit note elements and election elements. Our AI agents check each episode before the notice and the claim.
What must be included in documentation for each hospice visit?
Payer reviewers look for one story: visit notes, assessment, plan of care and diagnoses in agreement, with the level of care supported by the notes. Our AI agents flag disagreements before the claim.
The full study, PDF · 636 KB
Take the documentation fights once the plumbing works
The highest-value work left on the table is hard for honest reasons: the data is messy and the rules bend to the patient in front of you.