Revenue Audit Engine • V6A

Separate Medicare comparison without breaking your current workflow.

Upload census, diagnosis, and supporting documentation as before. Add optional Medicare comparison files to estimate captured vs predicted reimbursement. Medicaid stays separate and is not blended into this calculation.

Current Medicare run estimate

Upload files to run a Medicare comparison audit.

Run Medicare comparison audit

V6A keeps your current flow intact and adds payer separation, optional MDS comparison, and BIMS/PHQ support hooks.

Payer type

V6A comparison logic is active for Medicare only.

State

Used later for Medicaid-specific logic. No blended one-size-fits-all rules.

Census CSV

Diagnosis CSV

MDS / PDPM export (optional but recommended)

BIMS / PHQ-9 export (optional)

Supporting files (optional: PDF, CSV, TXT)

Leave blank unless you want to include supporting documents.

Ready.

Residents Reviewed

Immediate Revenue Opportunities

Predicted Daily Opportunity

Predicted Monthly Opportunity

Actual Captured Daily

Actual Captured Monthly

Estimated Missed Daily

Estimated Missed Monthly

Facility impact

$0/month currently at risk

Predicted vs actual Medicare comparison. Medicaid remains a separate future lane.

Top 10 opportunities

● Highest impact first

Owner queue

✓ Operational view

Comparison view

ℹ Actual vs predicted

Immediate revenue opportunities

● Critical — act now

Show critical residents

Next opportunities

● Watch — review next

Show watch residents