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These tabs are where problems surface: automated findings, denied claims, audit results, and the deadlines you have to meet.

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Audit Findings

Compliance audit findings from automated checks — wage violations, EVV mismatches, credential expirations. Columns: Severity · Type · Title · Status · Source · Created This is the most useful tab in the module for day-to-day work. OfficeRidge generates these findings from checks across other modules, so they catch problems while they are still cheap to fix.
Closing a finding does not fix its cause. Automated checks re-run, so a finding closed without correcting the underlying record will reappear. Fix the source, then close.
Severity levels are STANDARD, CONDITION, and IMMEDIATE_JEOPARDY.

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Disallowances

Claim disallowances and appeal tracking for denied or adjusted billing. Columns: Reason · Amount · Status · Appeal Deadline · Created
Appeal Deadline is a hard cutoff. A disallowance not appealed by that date becomes a permanent write-off regardless of merit. Filter on it weekly.
Group disallowances by Reason. A reason that recurs is a process problem, not bad luck — see Remittances for the adjustment codes behind them.

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Compliance Audits

Internal and external compliance audits with findings and corrective actions. Columns: Title · Type · Start · End · Auditor · Findings · Status Type distinguishes an internal self-audit from an external one. Both matter, but external audit findings usually carry deadlines.

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Compliance Calendar

Regulatory compliance deadlines, events, and milestone tracking. Columns: Title · Type · Due · Priority · Status · Completed This is your forward view. Licence renewals, report submissions, review cycles, and drill schedules all have dates you can miss.
Add recurring compliance obligations to Task Manager as well as the calendar. The calendar shows you what is due; a recurring rule makes sure someone is assigned to it.

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Working audit findings

1

Sort by severity

Handle IMMEDIATE_JEOPARDY and CONDITION findings before STANDARD.
2

Identify the source module

Source and Type tell you where the problem actually is.
3

Fix the underlying record

Renew the credential, resolve the EVV exception, correct the wage rate.
4

Close the finding

Record what was done.
5

Confirm it does not return

If the same finding reappears after the next check, the cause was not fixed.

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Appealing a disallowance

1

Check the appeal deadline

Work backwards from it. Appeals take time to assemble.
2

Establish the reason

The disallowance reason tells you what evidence you need.
3

Gather supporting records

Usually the EVV visit, the authorization, and the claim line. See Claim lines.
4

Submit and track status

Record the outcome against the disallowance.

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Troubleshooting

QAPI

Turn recurring findings into improvement initiatives.

Survey preparation

Preparing for external review.