GI APCM Compliance & Audit Readiness Checklist

Confirm the patient has two or more chronic conditions expected to last 12 months, such as Crohn's disease and Primary Sclerosing Cholangitis.

Record verbal or written consent for APCM services in the EHR, ensuring the patient understands potential cost-sharing for GI care coordination.

Flag IBD patients on biologics (e.g., Remicade, Stelara) who require structured monitoring and frequent medication adjustments.

Identify cirrhosis or chronic Hepatitis B/C patients who require regular HCC screening and MELD-NA score monitoring.

Ensure the patient is informed of how to access the GI care team after hours, utilizing AI triage systems to log these interactions.

Review and update the comprehensive care plan at least once every 12 months or following a significant IBD flare or hospitalization.

Incorporate specific laboratory monitoring dates (e.g., therapeutic drug monitoring, CBC, LFTs) into the patient's digital care plan.

Document specific GI dietary recommendations, such as low-FODMAP for IBS or low-sodium protocols for patients with ascites.

List upcoming colonoscopy, EGD, or FibroScan dates to ensure the care plan addresses long-term malignancy prevention.

Perform and document reconciliation of all GI-related medications, specifically checking for PPI overuse or NSAID contraindications.

Use AI call logs to automatically track time spent on patient coordination, symptom review, and pharmacy prior authorizations.

Document symptom frequency (e.g., Harvey-Bradshaw Index for Crohn's) captured via AI-driven follow-up calls between visits.

Set up automated triggers for liver ultrasound and AFP testing for cirrhosis patients to ensure timely screening compliance.

Log all communications with colorectal surgeons, hepatologists, or transplant coordinators as part of the APCM time requirement.

Ensure all AI-generated call transcripts and patient portal messages are integrated into the EHR for audit verification.