AFib APCM Compliance & Audit Readiness Checklist

Ensure the patient has a documented diagnosis of Atrial Fibrillation expected to last at least 12 months or until death.

Record verbal or written consent explaining APCM services, cost-sharing responsibilities, and the right to stop at any time.

Validate that the patient has at least one other chronic condition, such as hypertension or heart failure, to meet APCM criteria.

Document the mechanism for patients to reach a clinician after hours, including AI-triage pathways or on-call EP staff.

Develop and share a electronic care plan that addresses both rate/rhythm control and stroke prevention strategies.

Update and document the stroke risk score annually to support continued anticoagulation or watchman device monitoring.

Utilize AI-automated calls to confirm daily adherence to direct oral anticoagulants and log responses directly in the EMR.

For patients on warfarin, document the Time in Therapeutic Range (TTR) and INR monitoring frequency for audit safety.

Regularly log patient-reported symptoms like palpitations, dyspnea, or chest pain to evaluate the efficacy of rate control.

Standardize documentation for the 90-day post-ablation blanking period and schedule recurrence monitoring calls.

Ensure all AI-driven patient interactions are timestamped and summarized within the patient record for time-based billing.

Review and verify that at least 20 minutes of non-face-to-face care coordination were performed and documented.

Cross-reference APCM activities with MIPS measures, specifically focusing on anticoagulation therapy in AFib patients.

Document all communications with pharmacies regarding DOAC prescriptions, prior authorizations, or medication changes.

Maintain a record of educational materials sent to the patient regarding stroke signs and lifestyle modifications.