Home Health Billing Compliance Audit Template — CY 2026

Home Health Medicare Audit TemplateA structured, fillable audit template for home health agencies billing Medicare under PDGM.Use this template before an audit arrives to identify documentation gaps, or during an active ADR response to verify that your record is complete before submission.This is built for home health agencies, billing managers, compliance staff, and contracted auditors who need a practical way to review documentation, billing accuracy, and audit readiness.What’s InsideThis fillable PDF audit template includes 5 structured sections:Section 1 — Pre-Audit Readiness ChecklistA detailed checklist covering key home health audit risk areas, including:Physician Orders & Plan of CareCMS-485, verbal orders, recertification, and plan-of-care documentation.Face-to-Face Encounter Documentation90/30-day window, clinical findings, and homebound attestation.Homebound StatusIndividualized narrative requirements and the taxing-effort standard.OASIS-E Assessment AccuracyStart-of-care timing, transmission before the first claim, and HIPPS validation.Visit Documentation & Skilled Care JustificationSkilled note standards, aide supervisory visits, and discharge summary review.Billing & Coding ComplianceVisit reconciliation, revenue codes, LUPA threshold, and duplicate claim review.Medicare Conditions of ParticipationABN, NOMNC, patient rights, and staff credential documentation.Section 2 — Claim-Level Audit WorksheetA structured table to document findings for each claim reviewed, with space for claim details, audit notes, and error code reference.Section 3 — Top 10 Home Health Denial Triggers & FixesThe most common RAC and MAC audit findings for home health billing, paired with specific corrective actions for each issue.Section 4 — Documentation Requirements ChecklistA practical documentation checklist organized by episode phase:Every episodeEvery visitRecertificationDischargeUse it to confirm the record supports the services billed before submission or review.Section 5 — Corrective Action Plan TemplateA pre-formatted Corrective Action Plan template for major home health finding categories, including:DocumentationCoding and billingMedical necessityOASIS accuracyStaff trainingThe #1 Home Health Denial Trigger This Template AddressesOne of the most common home health denial risks is documenting homebound status as:“Patient is homebound.”That is not enough.This template helps you review whether the record includes an individualized homebound narrative, supports the taxing-effort standard, and gives you a clear audit checklist to verify every note before an auditor does.Best Used ForPre-audit readiness reviewsInternal self-auditsADR response preparationPDGM documentation reviewOASIS-E accuracy checksHome health claim-level reviewCorrective Action Plan documentationInstant AccessOne-time purchase.Instant PDF download.Fillable template format.Need All 7 Specialties?The complete Healthcare Biller’s Compliance Audit Vault includes all 7 specialty-specific templates for $297.Get all 7 templates for less than the cost of three individual purchases.DisclaimerNot legal advice.For operational compliance use only.© Kent Strategic Solutions | Healthcare Biller’s Compliance Audit Vault

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