Hospice eligibility requirements and the plan of care, run by our AI agents
Our AI agents track hospice eligibility requirements, plan-of-care visits and every notice window inside your home health or hospice agency; our experts set the rules and take the exceptions.
The plan-of-care, visit and eligibility workflows, in the order our study ranks them
- Assessment and update-visit timepoint managementIn the top 25 of 169 workflowsWorth it, ready now
- Plan-of-care adherence and visit frequency management per periodIn the top half of 169 workflowsWorth it, ready now
- Discharge, transfer and resumption managementIn the top half of 169 workflowsWorth it, ready now
- Hospice eligibility and prognosis review at each benefit periodIn the top half of 169 workflows
- Level-of-care transition managementIn the top half of 169 workflows
- Hospitalization and emergency visit risk managementIn the top half of 169 workflows
- Care plan, visit summary and physician communication lettersIn the top half of 169 workflows
- Symptom, pain and decline monitoring between visitsIn the lower half of 169 workflows
Talk with our experts about where your plan-of-care work slips first.
Talk about one workflow
Missed windows and missed visits cost you the period
Every assessment window, ordered visit and hospice notice runs on the same habit: watched by hand until it slips.
Windows missed on reschedules
When the visit carrying an assessment moves, the window closes before anyone notices.
Visits found missed at recert
Ordered frequencies tracked by hand, so shortfalls surface weeks after the period ends.
Transfers discovered late
A hospital transfer shows up on the census after the notices were already due.
Windows held, visits delivered, eligibility documented
Three workflows where our AI agents and our experts keep every window, visit and notice on time.
Each assessment lands within its defined window.
Timepoints get missed when the visit that carries them is rescheduled. Our AI agents generate each start-of-care, recert and hospice update timepoint with its window and escalate before it closes; our experts take the exceptions.
- Every recert and update window tracked per patient
- Missed timepoints escalated before the window closes
- The visit carrying it protected on the schedule
Each ordered visit becomes a daily obligation.
Missed visits are found at recertification, too late to fix the period. Our AI agents turn ordered frequencies into daily obligations and route the ones that slip to the scheduler and the manager; our experts set the rules.
- Ordered frequencies tracked against delivered visits
- Missed visits routed the day they slip
- Supervisory visits and therapy reassessments scheduled
Transfers are detected through hospital data feeds.
Discharges happen when the clinician stops visiting. Our AI agents read the record and hospital feed, trigger assessments and notices, and file the notice of election inside the five-calendar-day clock; our experts take exceptions.
- Transfer and revocation events detected from the feed
- Discharge assessment triggered when the event lands
- Notice of election filed inside the five-day clock
How our experts and our AI agents run the work
You bring your EMR, census, schedules, plans of care and staff; our experts watch the workflow and fix data before automation.
01What your agency brings
Your agency brings what already exists: systems, census, plans of care and the people who track windows by hand. Our AI agents run beside it all.
02Our experts map and set the rules
Our engineers and revenue-cycle specialists map the workflow with your team, fix the data it depends on, and set the rules the agents check against.
03Our AI agents run it live
Our AI agents work inside your EMR and payer portals, reading, checking, filing and routing, and flag every exception. Your team decides; our experts handle the rest.
Where custom AI built inside your agency beats the alternatives
For this work, your agency chooses among software bought for it, the EMR's own module and an outside firm. Here is what each is good at, and where it stops.
Custom AI built inside your agency, by Moative
Our engineers and revenue-cycle specialists sit inside your operation with your clinical, intake and scheduling teams, and build our AI agents for your workflows and systems. Your staff review every flag and decide.
- Our AI agents, built for your workflows
- Rules our experts set, visible to your staff
- Runs beside your EMR; you keep it
Scheduling and clinical software
Good at showing the schedule you have. It usually runs the same steps for every agency, so window rules stay manual work.*
Your EMR's care-plan module
Good at staying connected to the chart. It usually covers the standard path, so eligibility evidence and missed-visit tracking ride on workarounds.*
A QAPI or coding consultant
Good at finding the misses in a review. Most leave a report behind, and the work returns to your team.*
* These describe each category as commonly sold. Terms and coverage vary by product and by contract.
Your EMR stays, your team decides, one workflow starts the work
Do we replace our EMR to use this?
No. Our AI agents run beside your EMR, clearinghouse and payer portals, and you keep them. Nothing is replaced; the agents work inside what you already use.
Who makes the clinical and eligibility calls?
Your staff does. The agents never make a clinical call; they surface the evidence. Our experts set the rules with your clinicians, and your staff can change them.
How is this priced?
You pay a fee plus a part tied to what happens; the workflows automated set that part. New users never move the number.
What does our agency need ready?
Access for our experts to the EMR and the teams who work the workflow; the messiness is expected. Our experts fix the data as part of the work.
Every window held, every visit owed, every notice filed
If the work that hurts your agency is not on this page, our experts start the same way: one workflow, watched with your team, then automated inside your operation.
Common questions
What are the requirements for recertification in hospice care?
Recertification in hospice reviews eligibility at each benefit period: decline indicators, disease-specific criteria, and the interdisciplinary group's decision with rationale. Our AI agents assemble the evidence; our experts handle weak cases.
What are the CMS guidelines for general inpatient care (GIP) in hospice care?
General inpatient care manages symptom crises at the bedside, and its documentation gets reviewed. Our AI agents propose each transition with the criteria shown and prompt the step-down; our experts take the flags.
When must Oasis transfer discharge forms be completed?
OASIS transfer and discharge assessments are completed when the event happens: the move to hospital and back, or the discharge. Our AI agents trigger them from the record and the hospital feed.
How often should a plan of care be updated?
Each certification period carries its own plan of care, and the ordered disciplines and frequencies are the visits owed. Our AI agents turn them into daily obligations and catch slips the same day.
What is a symptom Follow-Up Visit (SFV) in HOPE?
A symptom Follow-Up Visit is the nurse-protocol contact that follows a change between visits. Hospice admission and update visits must fall inside their windows. Our AI agents triage red flags to the on-call nurse.
What is oasis in home healthcare?
OASIS is the assessment home health agencies complete at start of care, resumption, recertification and discharge. Our AI agents generate each timepoint with its window and escalate before it closes.
The full study, PDF · 636 KB
The work worth automating is the work whose mistakes travel
The work worth automating is not the easy work. It is the work whose mistakes travel.