Hospice certification & chart compliance
Hours of certification review, done in minutes. And physicians who write better ones every time.
HospiceDefender grades every Certification of Terminal Illness against the LCD criteria a reviewer uses, and scores whole charts against §418 — so gaps surface before a cert is signed, and your physicians see exactly what a complete narrative needs.
Graded result
Primary diagnosis
Heart disease (CHF)
Diagnosis category
Heart disease — LCD
Comorbidities
CKD · COPD
Required findings
Terminal prognosis stated
NYHA Class IV documented
Measurable decline since last cert
Recommendation: add an objective measure of interval decline — weight loss, PPS change, or recurrent hospitalization.
Sample output — synthetic, not patient data.
Why now
Hospice is the most-scrutinized line in Medicare — and documentation is where claims are won or lost.
The audits aren't slowing down.
UPIC, SMRC, TPE, and enhanced-oversight reviews run at once, and a single failed probe can put billing privileges at risk. The posture isn't reversing.
Documentation decides the claim.
The leading reason hospice claims are denied is a certification that doesn't substantiate a six-month prognosis — a diagnosis with no measurable decline, missing LCD indicators, a narrative that reads thin.
No one can coach every narrative.
Narratives drift into language that sounds clinical but reads weak to a reviewer, and a medical director can't hand-check every attending's every cert. The pattern shows up in a probe letter, not before.
Two reviews, one standard
Grade the narrative, and review the whole chart — both against the criteria an auditor would apply.
CTI Reviews
Every Certification of Terminal Illness, graded against its LCD
Each narrative comes back graded against the Local Coverage Determination criteria for its diagnosis — the diagnosis and comorbidities it captured, the required findings it has, the ones it's missing, and a recommendation to close the gap. Run them two ways:
Live in the IDG or QAPI meeting — grade a narrative as it's written and close the gap before it's signed.
Upload a whole caseload, an acquired catalog, or every recert due next quarter — 100% coverage instead of a sample, with a pass / fail / accepted on every record.
Bulk review
612
Total
541
Passed
58
Failed
Patient 04417 · Dr. Alvarez
Patient 04418 · Dr. Nguyen
Patient 04419 · Dr. Okafor
Sample output — one bulk review, synthetic data.
Chart Reviews
The whole record, ordered and scored against §418
Upload a chart bundle — election, F2F, CTI, plan of care, visit notes. HospiceDefender orders every document within its benefit periods, checks each requirement against §418 with a link back to the source, and compiles a scored compliance result.
Documents ordered within start-of-care, certification, and IDG periods
Per-requirement met / missing, each linked to its source document
One review serves ADR responses, ALJ hearings, and surveyor prep
Chart review
86%
Compliant
2
Defects
24/24
Docs
Election & certification
Certification signed and timely
source
Face-to-face encounter
Attestation not signed within window
source
Plan of care
Updated and aligned to level of care
source
Sample output — synthetic, not patient data.
Educate and validate
It catches the gap — and teaches the physician to stop leaving it.
Validate
Every narrative gets a clear outcome — passed, failed, or accepted with a documented reason — measured against the same LCD criteria an auditor applies. Gaps surface before the cert is signed or the claim goes out.
Educate
The physician sees which required findings their narratives consistently capture and which they keep leaving out. Across sessions, the habit moves in the right direction — without a medical director chasing every attending personally.
Insights
See the pattern, not just the page.
Reviewed narratives and scored charts roll up by physician, site, and LCD. “I think Dr. X's certifications are weak” becomes a number with a name on it — so you find the pattern when it forms, not when an auditor does.
What changes
Why agencies use it
Hours become minutes.
Screen-by-screen archaeology becomes one ordered, scored result — for a single narrative or a whole caseload.
Coverage, not sampling.
Every certification through the same lens at the same precision — not a ten-chart sample and a hope.
Physicians who get better.
Because the people writing the narratives see what's missing and learn it, the writing improves over time — not just this cert.
Defensible before anyone looks.
Charts and narratives read clean before an ADR, ALJ, or surveyor ever opens one.
Private beta
Get on the early-access list.
HospiceDefender is in private beta. Tell us about your organization and we'll reach out as we open to new providers — by invitation only, with no self-serve signup and no automated marketing follow-up.