This is not a generic form pulled from a search result. It was built from real clinical and caregiving experience, tested against the actual situation you are facing, whether that is a visit, a chart, or a hard conversation. Download it and start using it right away. There is no software to install and no training required first. Use it exactly as it is, or adjust it to fit how your team or your family already works. Either way, you get a clear, ready-made tool instead of one more thing to build from scratch.

And that might not be enough.

Here is a pattern real hospice auditors see over and over. A face-to-face note records a PPS score of 50%. The RN visit the next day records 40%. The recertification narrative, written the day after that, says 30%. All three of those documents are present. Every one is signed on time. And the claim is still denied because the reviewer cannot tell which number is correct. A presence checklist passes that chart. A real reviewer will not.

This is the gap that most chart audit tools miss. They ask, "Is the form here? Is it signed?" They never ask whether the story the chart tells actually holds together from one document to the next. That gap is where hospices lose money, and it is exactly what Targeted Probe and Educate (TPE) reviews are built to find.

The numbers make the stakes hard to ignore. In one recent Palmetto GBA hospice probe, 24 of 43 claims were denied, a 56% denial rate covering more than $106,000 of the claims reviewed. In a recent TPE cycle, 55% of denials cited an unsupported terminal prognosis and 44% cited an invalid election notice. TPE runs in up to three rounds, with 20 to 40 claims per round. Fail all three, and your agency can be referred to CMS for 100% prepayment review or extrapolated overpayment recovery. And your MAC's threshold for what counts as failing is not a mystery. It is published. Most hospices just never check their own numbers against it before the MAC does.

That is the whole idea behind the Hospice Internal Chart Audit Toolkit. It is a digital self-audit workbook that scores your charts the way a reviewer actually scores them: pass or fail, no partial credit, with both a claim error rate and a dollar error rate calculated side by side, because a single GIP-heavy denial can push your dollar rate far above your claim rate.

The workbook scores five domains: certification and face-to-face; the election statement and addendum; the plan of care and IDG documentation; visit documentation and level of care; and a fifth domain that most audit tools skip entirely: cross-document consistency. That fifth domain is a dedicated Cross-Check tab where you type in the same value — PPS, FAST stage, weight, principal diagnosis — from every document that mentions it. The workbook does the comparing for you and flags the mismatch. You are not relying on your eye to catch a contradiction buried three tabs apart. The formula catches it every time.

A narrative-quality rubric scores the physician narrative on the same terms a reviewer would use, checking for dated, patient-specific comparisons rather than the same stock language copied forward at every recertification. A staff-level findings view routes every failed item to the clinician who wrote it, so a vague "our documentation needs work" becomes a specific, teachable conversation. And the workbook schedules your re-audit 45 to 56 days after that education, the same rhythm a real TPE round follows, so if a real probe ever arrives, your team has already practiced the routine.

The full bundle includes the Audit Workbook itself, a Single-Chart Audit Form in a fillable PDF and Word so you can score a chart on paper or a tablet, a Denial Reason Reference Guide that walks through thirteen named denial reasons with their CMS codes and what the chart needed to avoid each one, an Education Log and Corrective Action Template for routing findings to your team, and a step-by-step getting started guide simple enough for anyone on your staff to follow on their first audit.

One thing this toolkit will not do: promise you a lower denial rate. That depends on what your team does with what it finds. And it will not claim to replicate an actual MAC review, because no one outside a MAC's review team knows their exact internal criteria. What it will do is give you an honest, internal look at your own error rate, scored on the same published logic and thresholds your MAC uses, before anyone outside your agency ever asks to see your charts.

If your agency has already been through a TPE round, or you have heard that a competitor just was, you already know what is at stake.

Get the Hospice Internal Chart Audit Toolkit today.