Hospice Coding and QA Services
Accurate coding. Stronger documentation. More time for patient care.
Cliniqon acts as an extension of your hospice team. We blend Clinix AI Engine pre-screening with certified clinical reviewers to catch documentation discrepancies before they affect reimbursement or audit standing. Our work covers ICD-10-CM terminal diagnosis sequencing, mandatory HOPE assessment reviews, active IDG meeting participation, and concurrent chart audits. Every chart comes back submission-ready, with a less than 24-hour turnaround time.
Our services include hospice diagnosis coding, admission and recertification reviews, care-plan support, interdisciplinary meeting documentation, and concurrent chart audits.
- Hospice ICD-10-CM Coding
- HOPE Assessment Documentation Review
- Plan-of-Care Review and Documentation Support
- IDT Meeting Participation
- IDT Meeting Documentation and Form Completion
- Concurrent Chart Audits and Recertification Documentation Review
HOSPICE ICD-10-CM CODING
Precision coding built for the complexity of hospice care
Protect your agency from audit exposure with coding designed specifically for end-of-life care. Cliniqon pairs the Clinix AI Engine with certified clinical reviewers to deliver three things: terminal primary diagnosis sequencing that matches physician certification language, valid comorbidity capture that supports terminal decline, and a guaranteed turnaround of less than 24 hours.
We also flag unsupported entries and documentation gaps for clarification, so your team catches discrepancies earlier and sends cleaner claims.
HOPE Assessment Documentation Review
Reduce documentation rework and keep quality reporting on track.
Cliniqon reviews HOPE documentation across admission, applicable update visits, discharge, and symptom follow-up when indicated. We flag missing information and inconsistent entries so your team can resolve gaps before submission, helping reduce avoidable corrections and support timely, accurate reporting.
- Identify Documentation Gaps Through HOPE, Plan-of-Care, and Recertification Reviews
- Reduce Rework with Concurrent Clinical Documentation Reviews
- Support Accurate Claims with Hospice ICD-10-CM Coding
Hospice Plan-of-Care Review and Support
Cliniqon prepares and reviews individualized care-plan documentation. We confirm that patient and family goals, symptom-management needs, interventions, and service frequency are clearly captured.
Any gaps or inconsistencies get flagged so your team can resolve them without extra back-and-forth.
Interdisciplinary Meeting and Documentation Support
Cliniqon assists with meeting preparation, patient summaries, and documentation of changes in condition and follow-up actions. We help your team keep information organized and next steps clearly documented.
Your hospice interdisciplinary group retains responsibility for clinical decisions.
Cliniqon's Hospice coding workflow
Cliniqon hospice coding services combines Clinix AI pre-screening with certified clinical reviewers. The result is audit-proof ICD-10 coding, CTI alignment, and HOPE QA, all delivered within a 24-to-48-hour turnaround.
Concurrent Hospice Documentation Review
Identify gaps across the patient's ongoing record.
Admission records, medical history, and hospice election documentation
FAQs
It is reviewing, validating, and correcting hospice clinical documentation and codes to ensure accurate, compliant reimbursement.
We review admissions, recertifications, discharges, plan of care (POC), and concurrent documentation.
We provide hospice ICD-10-CM coding, HOPE assessment documentation reviews, plan-of-care review and support, interdisciplinary team meeting and documentation support, and concurrent chart audits. Our reviews also cover admission, recertification, and discharge documentation, helping your team identify gaps early, reduce avoidable rework, and support billing and audit readiness.
Yes. Cliniqon reviews HOPE documentation for admission, applicable HOPE Update Visits, discharge, and symptom follow-up when indicated. We flag missing information and inconsistencies to help your team reduce documentation rework and support timely, accurate quality reporting.
Yes, we work with hospices of all sizes, from startups to nationwide providers.
Yes, all our services follow HIPAA and CMS compliance standards.
We offer less than 24 hr turnaround time for your hospice chart coding and QA.
Outsourcing hospice coding and clinical quality assurance eliminates the overhead of in-house recruitment, salaries, benefits, and ongoing coder training. It also solves the acute shortage of specialized hospice coders, provides coverage during volume surges or staff turnover, and supports 24-to-48-hour turnaround times. External certified coding teams add an objective second layer of audit compliance, which reduces billing errors, claim rejections, and Additional Documentation Requests (ADRs).
Cliniqon's hospice coding team consists of credentialed specialists holding HCS-H, HCS-D, CPC, and CCS designations, alongside certified RN clinical reviewers. Our specialists complete continuous education on CMS HOPE assessment standards, primary terminal diagnosis sequencing, Physician Certification of Terminal Illness (CTI) alignment, Medicare Benefit Policy Manual Chapter 9, and Hospice LCD guidelines.
Hospice-specific coding QA reduces claim denials, Additional Documentation Requests (ADRs), and Targeted Probe and Educate (TPE) audit exposure. A multi-tier QA workflow conducts pre-bill clinical record reviews before claims are released. Hospice care follows its own regulatory framework, so coding has to do more than sequence diagnoses. It must validate terminal prognosis and align with Physician Certification of Terminal Illness (CTI) language.
Adapting generalist or home health coding workflows can leave hidden compliance gaps, missed comorbidity capture, and audit exposure under Medicare review. A specialized hospice QA model integrates Clinix AI pre-screening with certified clinical reviewers and active IDG alignment to produce submission-ready, audit-proof claims.
Cliniqon's coding team works inside your agency's existing EHR/EMR software through secure, HIPAA-compliant remote access.
We integrate with leading platforms, including:
- Homecare Homebase (HCHB)
- WellSky (Kinnser)
- MatrixCare
- Axxess Hospice
- Netsmart (myUnity / CareFabric)
- KanTime Healthcare Software
Charts are coded and QA'd in your clinical queue without disrupting daily operations.
Our standard Service Level Agreement (SLA) delivers completed chart coding and QA reviews within 24 to 48 hours from the time documentation is available in the queue. We also offer expedited same-day turnaround for priority admissions and month-end billing cutoffs.
Cliniqon provides hospice coding and QA services built around current CMS HOPE requirements, replacing outdated HIS-era workflows. Our hybrid model pairs Clinix AI Engine pre-screening with certified clinical reviewers, licensed RNs and PTs, to evaluate documentation at all mandatory HOPE time points. That includes Admission, Recertification, and Discharge.
Cliniqon gives hospice agencies access to experienced coding and QA support without carrying the cost and complexity of building the same expertise in-house.
Our team supports ICD-10-CM coding, documentation review, care-plan alignment, recertification review, and quality assurance. That keeps coding accurate and clinical documentation consistent.
What that looks like in practice:
- Lower the cost of recruiting, training, and retaining additional coding staff
- Add specialized hospice coding expertise without growing internal headcount
- Cut the time clinical and administrative teams spend on coding-related review and corrections
- Improve consistency across coding and QA workflows
- Catch documentation gaps before charts move further through internal review
- Maintain a structured second level of quality review without building a larger internal QA team
For hospices looking to control operating costs while holding strong coding and documentation standards, Cliniqon offers a more efficient path than expanding an in-house coding and QA function.
Cliniqon provides integrated clinical documentation review and coding quality assurance for hospice and palliative care agencies. Our team works directly inside your agency's Electronic Medical Record (EMR) system, including WellSky, Homecare Homebase, MatrixCare, Kinnser, and Axxess, and reviews patient records within a 24-to-48-hour operational turnaround.
Core Review Scope
- Terminal Diagnosis & CTI Alignment: We verify ICD-10 primary terminal diagnosis sequencing against Physician Certification of Terminal Illness (CTI) statements and identify secondary comorbidities that document terminal decline.
- HOPE Assessment Compliance: We audit mandatory Hospice Outcomes and Patient Evaluation (HOPE) data at admission, recertification, and discharge timepoints, checking each one against daily clinical notes.
- Plan of Care (CMS-485) & IDG Integration: We validate individualized care plans within the mandatory 5-day CMS window and support Interdisciplinary Group (IDG/IDT) meetings with 15-day clinical condition summaries.
- Discipline-Wide Concurrent Audits: Before claim release, we audit visit notes across every care discipline, including nursing, therapy, medical social work, chaplain, and hospice aides.
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