APCM Compliance & Audit Checklist for MEDITECH Users

Ensure Expanse Ambulatory APCM templates are mapped to discrete clinical data elements for automated reporting.

Validate that the 'Consent for APCM' is captured as a scanned document or discrete field within the MEDITECH EMR.

Configure MEDITECH clinical alerts to notify providers when a patient meets APCM eligibility criteria based on chronic condition counts.

Ensure the Problem List is updated and reconciled within the Ambulatory module to reflect active chronic conditions.

Setup 'Time-Tracking' shortcuts in MEDITECH to record non-face-to-face clinical staff time for monthly billing requirements.

Map MEDITECH 'Patient Portal' interactions to count toward monthly APCM engagement minutes automatically.

Confirm APCM CPT codes, including G0511 for RHC/FQHC or standard CCM codes, are active in the MEDITECH B/AR dictionary.

Audit the link between the Hospital Account Record (HAR) and Professional Fee billing for Critical Access Hospital compliance.

Verify that the MEDITECH billing scrubber identifies missing provider signatures on APCM claims before submission.

Validate that the Place of Service (POS) code is correctly mapped for hospital-based outpatient departments in MEDITECH.

Establish a process for reconciling MEDITECH remittance advices to identify and appeal APCM-specific denials.

Review the MEDITECH 'Charge Capture' audit trail for unauthorized manual code overrides on APCM claims.

Integrate AI call logs directly into the MEDITECH 'Communications' or 'Notes' section to create a permanent audit trail.

Configure AI workflows to identify rural patients requiring transportation assistance and log these needs in MEDITECH.

Ensure AI-driven after-hours call summaries are routed to the MEDITECH 'Provider Desktop' for clinical review and sign-off.

Use AI to automate the monthly 20-minute engagement check-ins required for APCM billing, reducing staff burden.

Map AI-collected social determinants of health (SDOH) data to discrete MEDITECH Expanse fields for population health tracking.

Validate that AI-transcribed patient interactions meet HIPAA compliance standards for storage within the MEDITECH environment.

Build a custom MEDITECH Data Repository (DR) report to track aggregate APCM minutes per patient across the practice.

Schedule a monthly 'Missing Documentation' report in MEDITECH to catch unsigned APCM care plans before billing.

Audit the MEDITECH 'Audit Trail' for clinical staff access to APCM records to ensure data privacy and compliance.

Verify that the MEDITECH 'Population Health' module correctly flags patients for APCM reassessment every 12 months.

Maintain a cross-walk between MEDITECH clinical notes and the final APCM claim for easy retrieval during CMS audits.

Conduct quarterly spot-checks of MEDITECH Expanse 'Care Plans' to ensure they are patient-centered and updated.