How it works

From the inbox to the audit binder.

A document arrives. We read it, sort it, and hand it to the right person. Your team works the case in the right tool. By the time CMS asks, the audit record is already assembled, so there's no scramble.

The document arrives.

Fax, email, the member portal, HPMS, a monitored inbox, a direct upload: every one gets a timestamp the moment it lands, and duplicates are caught before they pull a person in.

PSI · Document intake  ·  42 CFR § 422.504

It gets sorted.

The platform checks each document against a known set of rules first, and only looks harder when the call is close. Every routing decision is logged with its reason, and three confirmed corrections from your team change the rule for next time.

PSI routing  ·  decisions logged per case

The right team works the case.

Memos go to Mandate Tracker, universe files to Audit Scrubber, audit findings to CAP Management, privacy incidents to Privacy, network changes to Network Adequacy, FDR contracts and screenings to FDR Oversight. Each tool stands on its own, but they share one case file.

Compliance Stack  ·  shared case file

The record is already there.

Universe rows, audit receipts, evidence, and consent trails are produced as the work happens, and the Calendar rolls all of it into one view for the compliance officer. When CMS asks, there's nothing left to reassemble.

Audit Scrubber · Calendar  ·  append-only, timestamped

A day in the platform

Six things that show up on a normal Tuesday.

Not a stylized day. These are the case types compliance teams handle on any business day.

Mandate Tracker

A CMS memo arrives.

The action items are pulled out, the informational sections fall away, and each item routes to its owner with two due dates: the regulator's, and a safer internal one.

Audit Scrubber

A CDAG universe is staged for submission.

The Scrubber validates it row by row and surfaces the malformed timestamps, missing primary IDs, and lookup mismatches. You get the fix list before you submit, not after the auditor opens it.

CAP Management

A new audit finding opens a CAP.

The lifecycle starts (team invite, 5 Whys, milestone tracking, leadership sign-off), and the CFR citation that triggered the finding rides along from open to close.

Privacy

A possible HIPAA exposure is reported.

The 60-day clock starts at intake and the risk-assessment template runs. State notification rules and the HHS portal output stay a click away from the investigator.

Network Adequacy

A specialty drops below the HSD minimum in one county.

The finding is queued for the network team and the map updates. If recruitment won't close it, the exception packet drafts itself with the rationale and the supporting data.

CTM

HPMS routes a CMS complaint to the plan.

The daily HPMS poll picks up the case and the two-day Immediate Need clock starts. Beneficiary and provider stay in their own lanes, and closure proof attaches to the audit record.

Send us a memo or an audit finding.

We use your own data, not slides. Thirty minutes with the tool that fits, and your team is at the keyboard by the end of the call.