PMD packets are rarely complete on first pass. We show exactly what is missing.

Not a generic AI chart summary. A PMD documentation verification engine with deterministic policy checks and narrative review support.

Deterministic checks for dates, required elements, and contradictions. Narrative review for weaker clinical wording. Your team stops chasing and starts submitting.

Open DME Workspace
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11
LCD coverage factors
checked per case
21.4%
DMEPOS improper payment rate
(CMS CERT 2024)
35.4%
Wheelchair options/accessories
improper payment rate (CERT 2024)

Why PMD cases stall before submission.

The expensive problem is not reading the packet. It is figuring out what is actually wrong with it.

  • Physician note is missing a required less costly alternative rule-out
  • WOPD is missing one of the 7 required elements
  • Documentation arrives in pieces over days or weeks
  • Staff chase the wrong addendum because the gap is not clear
  • Packet looks complete but still fails LCD review on submission
  • F2F date is outside the 6-month window but nobody checked
  • Specialty eval recommends a scooter but the WOPD orders a power wheelchair
  • Home assessment exists but does not address doorway widths
  • Physician concurrence is missing and nobody asked for it
  • Order was forwarded 47 days after F2F (2 days past the 45-day limit)

Each of these is a non-affirmation or a denial waiting to happen. The problem is not that your team does not know LCD requirements. The problem is that checking all 11 factors across multiple documents takes hours per case, and incomplete packets get submitted because the gap was not visible.

How the workspace works.

Two verification layers. From incomplete packet to submission-ready verdict.

First, deterministic checks verify the mechanical requirements: date timelines, written order elements, document consistency, and factor-level coverage rules tied to LCD L33789. Second, a narrative review layer assesses whether the clinical wording actually supports the Medicare standard. The most important claim-blocking checks are transparent and traceable.

Step 1
Select equipment category and beneficiary state
Step 2
Evidence Locator finds coverage language in the chart
Step 3
Missing factors identified with required document source
Step 4
Strengthening guidance tells staff what to request
Step 5
Readiness report: submit, hold, or strengthen

What the readiness report gives your team.

Not a summary. A factor-by-factor submission checklist with next steps.

Claim-Blocking Issues

  • Missing mobility limitation documentation
  • Less costly alternatives not ruled out
  • F2F outside the 6-month window
  • WOPD missing required elements
  • Order forwarding past 45-day limit

Verification Results

  • Date arithmetic (F2F, forwarding, delivery)
  • 7-element WOPD presence check
  • Cross-document contradiction alerts
  • Practitioner name match (F2F vs. WOPD)
  • Device type consistency across documents

Next Steps

  • Which factor needs strengthening
  • Which document the fix belongs in
  • What the addendum should address
  • LCD page reference for each requirement
  • PDF export for file or physician request

What this changes for your team.

Not faster reading. Less wasted work.

  • Fewer back-and-forth requests. The report names the exact factor, the exact document, and the exact language that is missing. Staff stop asking for vague addendums.
  • Faster identification of missing documentation. 11 LCD factors checked in seconds instead of hours of manual cross-referencing.
  • Fewer preventable non-affirmations. Catch missing WOPD elements, timing breaches, and rule-out gaps before the claim goes to the DME MAC.
  • Less manual LCD cross-checking. LCD L33789 and Policy Articles A52503/A52504 are pre-loaded with page references. No more flipping through the policy for each case.
  • Clearer provider addendum requests. Instead of "we need more documentation," the request becomes "the F2F note needs to address why a manual wheelchair is insufficient due to upper extremity limitations."
  • Submission confidence. The readiness report shows whether to submit, hold, or strengthen. Your team knows before the claim goes out.

Before and after.

Without the workspace

  • Packet arrives incomplete. Staff reads everything to figure out what is missing.
  • Unclear which document needs the fix. Addendum request is vague.
  • Physician sends back a note that still does not address the real gap.
  • WOPD is missing quantity or NPI. Nobody catches it until after submission.
  • F2F was 187 days before the order. Seven days outside the window. Discovered on denial.
  • Case goes back and forth 3-4 times before it is actually submission-ready.

With the workspace

  • Missing factors surfaced immediately. Staff knows exactly what is absent.
  • Each gap shows the required document source. The request is specific.
  • Addendum request says "address why cane, walker, and manual wheelchair are insufficient."
  • 7-element WOPD check flags the missing quantity before submission.
  • Date arithmetic catches the 187-day F2F gap instantly. Case held for new encounter.
  • First addendum request is the right one. Rework cycle drops to one round.

Sample PMD case.

A Group 1 power wheelchair case. Here is what the packet looked like, what the system caught, and what needed to be fixed.

CASE: GROUP 1 POWER WHEELCHAIR (K0823) JURISDICTION: JC (CGS) | LCD L33789 | PRIOR AUTH REQUIRED
DOCUMENTED: MOBILITY LIMITATION (FACTOR 1)
Beneficiary has documented mobility limitation affecting toileting and meal preparation. Ambulation limited to 15 feet with rolling walker. Falls 2x/week. Functional limitation confirmed in F2F note.
NEEDS SUPPORT: DEVICE TYPE JUSTIFICATION (FACTOR 2)
DOCUMENTATION GAP F2F note documents that the beneficiary "needs a power wheelchair" but does not include ruling-out language for: (1) cane, (2) walker, (3) manual wheelchair. Scooter is ruled out due to trunk instability. LCD requires each less costly alternative to be individually ruled out.
LCD L33789, p. 4 "A cane or walker has been considered and the beneficiary is unable to use these devices."
WHAT TO REQUEST Physician addendum to the F2F note documenting: (a) why a cane is insufficient given fall history, (b) why a walker does not meet mobility needs beyond 15 feet, (c) why a manual wheelchair is not feasible due to upper extremity function. Each alternative must be addressed individually.
CLAIM-BLOCKING: WOPD INCOMPLETE (FACTOR 5)
MISSING ELEMENTS Written order is missing: (1) quantity, (2) treating practitioner NPI. 5 of 7 required elements present. LCD requires all 7.
WHAT TO REQUEST Return WOPD to ordering physician for completion. Add quantity (1) and practitioner NPI. Do not submit until all 7 elements are present.
VERIFIED: ORDER FORWARDING (FACTOR 6)
F2F date: 2025-09-14. Order forwarded: 2025-10-08. 24 days. Within 45-day limit.
CONTRADICTION DETECTED
Specialty evaluation references "scooter assessment" but WOPD orders K0823 (power wheelchair). Verify that the final device recommendation matches across all documents before submission.
VERDICT: HOLD. Fix 2 factors before submission. 3 of 5 checked factors documented. 2 require action. 1 contradiction flagged.

Built for traceability. Your data stays yours.

Precise boundaries. No overclaims.

Deterministic, not opaque Claim-blocking PMD checks are deterministic, traceable, and tied directly to LCD requirements. When the system flags a timing failure, missing order element, or contradiction between documents, you can see exactly what triggered it and where it came from.
Evidence Locator: browser only The Evidence Locator scans PDFs entirely in your browser using pdf.js. The medical record is never uploaded to any server. It stays on your machine.
Coverage check: text descriptions sent When you submit the coverage check, the text descriptions you confirmed or typed are sent to the server for policy verification and report generation. Preview output may be stored temporarily so the result can load and download.
No training on your data We do not use your documents or descriptions to train our own models. Where model processing is used, only the submitted verification content needed for the check is sent.
Infrastructure Hosted on SOC 2 Type II and ISO 27001 certified infrastructure with DDoS protection and network-isolated environments.

Common questions.

Is this just AI?

No. The core PMD verification engine is deterministic. It uses rule-based checks for timeline math, written order requirements, cross-document contradictions, and other claim-blocking requirements tied to the LCD. A separate narrative review layer helps identify weak or incomplete clinical wording in text-heavy sections. The product is not a black-box chart summary tool. It is a documentation verification workflow with an assisted text-review layer.

Does my medical record get uploaded to a server?

No. The Evidence Locator runs entirely in your browser using pdf.js. The PDF never leaves your computer. When you submit the coverage check, only the text descriptions you confirmed are sent for policy verification.

What equipment categories are supported?

Power mobility devices (LCD L33789) with 11 coverage factors. Additional equipment categories are in development.

Does this guarantee my claim will be approved?

No. The system measures whether your documentation addresses LCD coverage requirements. It does not assess medical necessity, predict claim outcomes, or replace professional judgment. Your team decides whether to submit.

Get your next PMD packet submission-ready.

Open the workspace. Walk through the LCD factors. See exactly what is missing, where it belongs, and what to fix.

Try a Sample Case No signup. Pre-loaded PMD packet. See the real verification engine in action.
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