NigatTechnology

Healthcare evidence-operations product

Find missing RCD evidence before the packet is submitted.

RCD PacketOps is a file-first evidence and reviewer workbench for regional home-health coding, OASIS, QA, documentation-review, and revenue-cycle partners managing Review Choice Demonstration packets.

The product hypothesis

A file-first reviewer workbench that sits beside your EHR.

RCD PacketOps is designed for regional firms that already employ credentialed reviewers and manage packet preparation for multiple home-health agencies. The opportunity depends on measurable reviewer-time savings and partner capacity.

Proposed capabilities

  • Requirement-to-evidence coverage matrix
  • Source-cited missing and conflicting evidence
  • Versioned rules with explicit human-decision boundaries
  • Reviewer comments, packet versions, and resubmission history
  • UTN and outcome tracking without replacing the submission portal

Synthetic product demonstration

From fragmented records to a source-cited review queue.

No PHI is used. The scenario demonstrates workflow design, not clinical accuracy or production readiness.

Synthetic episodeRCD-DEMO-001
A resubmission must carry the prior UTN and the last non-affirmation letter, or it is returned as incomplete.

Submission tasks

Nigat AI engineEvidence extraction and checks

Ready

Reason codes checkedRun the review

Idle. Run the review to trace each reason code to its source document.

Documents in this task

    Configured findingSelect a reason code to open its source

    Run the review, then choose a code to see the document, page and field it was checked against.

    Human boundary: configured checks can identify evidence presence, identity, dates, signatures, and linkage. Credentialed professionals retain clinical, coding, homebound-status, medical-necessity, and final submission decisions.

    Synthetic episode, no PHI. The submission tasks, document lists and reason codes are taken from the Palmetto GBA pre-claim review form and checklists and the CMS reason code list. The episode itself, and which items pass or fail, are generated fresh on every run.

    01

    Regional coding and OASIS review firms

    Manage source-cited packet review across several agency clients.

    02

    Home-health QA and documentation-review partners

    Resolve evidence gaps while retaining professional judgment.

    03

    Multi-agency revenue-cycle operators in RCD states

    Measure packet volume, reviewer effort, resubmissions, and outcomes.

    Human and security boundaries

    • Not an EHR or OASIS authoring system
    • Not a coding engine or medical-necessity decision maker
    • Not a claim of denial reduction or clinical accuracy
    • Credentialed reviewers retain clinical and coding decisions

    Start with the operating problem

    Show us where the work slows down.

    You do not need a polished technical brief. Describe the decision, handoff, report, document workflow, or AI initiative that is harder than it should be.

    Start the conversation

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