Therapy & Ancillary Capture Auditor
Were documented, authorized services reconciled to billing? Would compare delivered-service documentation, authorizations, and charge records where the operator provides those services, highlighting discrepancies rather than maximizing utilization.
Designed · not built or operator-validated · as of November 8, 2026
How it is designed
- Inputs it would read
- Service documentation, payer authorization, charge records, applicable billing rules.
- What it would produce
- A documentation-to-charge exception queue.
- Accountable owner
- Reimbursement specialist and clinical leader
- What it never does
- Does not order therapy, establish medical necessity, or submit claims.
- Gate before any claim changes
- Qualified reimbursement review of service, authorization, and billing matches.
Questions executives ask
Is the Therapy & Ancillary Capture Auditor available today?
No. The Therapy & Ancillary Capture Auditor is designed and has not been built or validated with an operator as of November 8, 2026.
Can the Therapy & Ancillary Capture Auditor make decisions?
No. Does not order therapy, establish medical necessity, or submit claims. The operator defines what information governs and separately authorizes any action; model confidence never creates authority.
Is operator data used to train it?
No. Operator, resident and workforce data are not authorized for model training or fine-tuning, and there is no cross-operator training.
Other revenue integrity & census agents
Where this matters
Every agent starts after the record is governed
The first step is a bounded proof on one operator’s authorized historical files: one contested occupancy figure, reconciled and approved by the operator.
Explore the Founding Operator ProgramGoverning Agentic AI in Senior Housing & Care
Illustrative framework · 2-page PDF · Design commitments, not demonstrated deployment.