GRSA Basic Notes Review & Risk Analysis

Reduce your CMS audit risk. Protect your reimbursement. Strengthen your documentation.

In today’s environment of increased scrutiny—driven by ADRs, UPIC audits, and programs like WISeR—defensible documentation is no longer optional. Even clinically appropriate care can be denied or recouped if the medical record does not fully support medical necessity, product utilization, and billing accuracy.

Our Basic Notes Review & Risk Analysis is designed to proactively identify documentation and coding gaps that put your practice at risk for denials, clawbacks, and compliance exposure.

This service provides a targeted, expert review of real patient cases to ensure your documentation aligns with CMS expectations and payer policies.

What’s Included

Project Goals

1.         Review clinical notes related to HCT/P usage.

2.         Assess audit risk and determine gaps in charting to facilitate audit appeal strategy.

Project Scope

1.         Review one note for each of 3 cases (typically one chart from each of 3 patients) providing LCD/NCD alignment analysis comparing to “Policy, Procedure, Payment” (PPP) paradigm

2.         Deliver Notes Review Report, including specific gaps to be corrected to minimize reimbursement-related risks.  Consultant to be contracted separately to resolve gaps, provide audit/appeal support, and develop additional customized training.

Deliverable

Chart Review Report (Actionable Risk Assessment)

You will receive a comprehensive written report that includes:

• Identified documentation and coding gaps

• Specific risk areas that could trigger denials or audits

• Clear, actionable recommendations to strengthen compliance

• Prioritized remediation guidance

Important Note

This service is a diagnostic assessment only. Implementation support—including documentation correction, appeal support, staff training, policy and procedure development can be provided under a separate consulting engagement tailored to your practice.

Who This Is For

• Wound care clinics using advanced therapies (CTPs/HCT/Ps)

• Practices experiencing denials or payment delays

• Providers concerned about CMS audits or ADRs

• Organizations preparing for compliance reviews or scaling services

Why It Matters

Failure to meet CMS documentation standards can result in:

• Claim denials

• Payment recoupments (clawbacks)

• Pre-payment review or audit escalation

• Long-term reimbursement disruption

This review helps ensure your practice is aligned with the PPP framework: Policy, Practice, and Payment—the foundation of defensible reimbursement.