Patient Chart Compliance Overview
FHIR R4 · ASAM 4th Ed. criteria · Cigna/Evernorth billing rules · Last sync: 6 minutes ago · 164 active patients across 3 South Florida facilities
Charts open >72 hrs
8
↑ 2 from yesterday · 3 over 96 hrs
Unsigned treatment plans
5
Oldest unsigned: 4 days
UR auth expiring <48 hrs
6
2 expiring in <18 hrs · Cigna
Missing / expired consents
4
ROI & treatment consent gaps
Charts fully compliant
141
↑ 3 since morning · 86% of census
Active Patient Flags
13 critical
10 warnings
Filter:
| Patient | Facility | Flag / Rule | Time Open | Severity | Clinician | Type |
|---|
Showing all records
Click a row to view patient detail
Compliance by Facility
Updated hourly
Miami — Sunrise
72%
Ft. Lauderdale — Serenity
84%
Boca Raton — Harmony
93%
AI Content Audit
AI Check
Group Note
ASAM Check
Goal Linkage
DH
D. Harris · DH-6630
AI findings — group note individualization check
Group note is not individualized
Note text is 94% similar to 3 other patients in the same group session. No mention of this patient's specific response, participation level, or connection to their treatment goals.
"Patient participated in group therapy. Discussed coping skills and relapse prevention strategies. Patient verbalized understanding of material presented."
Similarity score vs. group peers
94%
Medical necessity language missing
No ASAM dimension language detected. Note does not state why this level of care is clinically required or reference Dimensions 5 or 6. Cigna concurrent review is likely to be challenged.
Suggested addition (AI-generated)
"D. Harris participated in today's IOP group, demonstrating limited engagement with reflective exercises (Dim. 3). Patient continues to express ambivalence regarding outpatient step-down (Dim. 4). High relapse potential remains given minimal recovery support at home (Dim. 5–6). Residential IOP level of care remains clinically indicated."
Treatment goal linkage — passed
Note references Goal 2 (coping skill development). Acceptable linkage detected.
MR
M. Rodriguez · MR-4821
ASAM 4th Ed. dimension coverage scan
Dim 1 ✓
Dim 2 ✓
Dim 3 ✗
Dim 4 ~
Dim 5 ✗
Dim 6 ✗
"Patient attended AM group session and individual therapy. CIWA-Ar: 4 — mild withdrawal, stable. Patient reported sleeping better. Goals for today: continue medication compliance. No mention of co-occurring psychiatric issues. Patient 'seems motivated.' Will continue current treatment plan."
3 of 6 ASAM dimensions missing — Cigna denial risk
Evernorth reviewers require documentation on all 6 ASAM dimensions for residential (3.5) concurrent review. Dimensions 3, 5, and 6 are absent from this note. This is a top denial trigger for Cigna commercial plans.
Suggested additions
Dim 3: "Patient carries diagnosis of MDD (F32.1) and PTSD (F43.10), both currently destabilizing..." | Dim 5: "High relapse risk — 3 prior SUD treatment episodes..." | Dim 6: "Home environment includes active substance users; step-down to outpatient not safe at this time."
LM
L. Martinez · LM-9001
Treatment goal linkage analysis (FHIR CarePlan cross-reference)
"Patient attended PHP programming. Participated in group discussions. Working on coping skills. No behavioral incidents. Will continue current level of care."
Active CarePlan Goals (FHIR)
| Goal | Status | Referenced in note? |
|---|---|---|
| G1 — Achieve 30-day sobriety | Active | Not found |
| G2 — Develop 3 coping skills | Active | Vague mention |
| G3 — Attend family therapy 2×/wk | Active | Not found |
| G4 — Medication compliance daily | Active | Not found |
Progress note does not reference treatment plan goals
0 of 4 active CarePlan goals are referenced in today's note. Behavioral health auditors and Cigna reviewers expect clinician notes to tie observations to specific treatment goals each session.
MR
Patient Name
Chart status
Admission date—
Level of care—
Last progress note—
Treatment plan—
Consent status—
Discharge summary—
Payer / UR Authorization
Payer—
Auth #—
Auth expiry—
Next concurrent review—
Billing code—
ICD-10—
Active Compliance Flags
FHIR Resources Checked
Compliance Rules Active in This Demo
Click a KPI card or filter to narrow the patient list
R1 · Progress note >72 hrs
R2 · Treatment plan stale >7 days
R3 · Treatment plan unsigned
R4 · UR auth expiring <48 hrs
R5 · Consent missing / expired
R6 · Discharge summary >24 hrs
R7 · MAR medication gap
R8 · AI: Group note non-individualized
R9 · AI: ASAM dimensions absent
R10 · AI: Note not linked to treatment goals
C1 · Cigna: CPT bundling error
C2 · Cigna: ICD-10 incomplete
C3 · Cigna: Concurrent review due
| Rule | FHIR Resource | Check type | Threshold | Patients affected |
|---|---|---|---|---|
| R1 — Progress note overdue | DocumentReference | Auto-detect | No note in >72 hrs | 8 patients |
| R3 — Treatment plan unsigned | CarePlan + Provenance | Auto-detect | No clinician signature | 5 patients |
| R4 — UR auth expiring | Coverage + CoverageEligibilityRequest | Auto-detect | <48 hrs to expiry | 6 patients |
| R5 — Consent missing/expired | Consent | Auto-detect | Absent or status ≠ active | 4 patients |
| R8 — Group note non-individualized | DocumentReference | AI check | Similarity >80% across group | 3 patients |
| R9 — Medical necessity absent | DocumentReference | AI check | ASAM dims <4/6 documented | 5 patients |