01
Documentation & Clinical Records
Session notes, treatment documentation, templates, and alignment with billed services.
Safe Harbor
Compliance & Risk Management
The Best Time to Find a Compliance Gap Is Before Someone Else Does.
A paid claim isn't necessarily an audit-proof claim. We help healthcare organizations examine the processes behind their documentation, billing, and service delivery—and make meaningful improvements before small gaps become expensive problems.
Human-led. Technology-enabled.
Technology Can Flag a Problem. Experience Helps Solve It.
Automation and AI can make documentation reviews, claims monitoring, and compliance workflows more efficient. We believe in using those tools.
But identifying a discrepancy is not the same as understanding why it happened—or helping an organization prevent it from happening again.
Our team brings hands-on healthcare operations experience to the process. We look beyond individual records to examine the workflows, systems, training, and decisions behind them.
We can help your organization use technology more effectively while providing the human guidance, staff education, and implementation support needed to turn findings into lasting operational improvements.
What we assess
Look Beyond the Record. Understand the Process.
02
Claims & Billing Integrity
Coding support, billed units, documentation reconciliation, and payer-specific billing requirements.
03
Credentialing & Authorizations
Provider qualifications, enrollment, authorization controls, and service eligibility.
04
Payer & Regulatory Requirements
Applicable payer policies, contract obligations, and operational compliance processes.
05
Systems & Internal Controls
EHR configurations, workflows, quality checks, reporting, and escalation procedures.
06
Organizational Risk & Oversight
Training gaps, accountability, leadership controls, and recurring sources of exposure.
ABA-specific operational expertise
In ABA, the Details Behind Every Unit Matter.
ABA documentation, provider qualifications, supervision, authorizations, and time-based billing must work together. We examine how clinical, scheduling, credentialing, and billing teams reconcile what was delivered, documented, and claimed.
- CPT 97153: documentation and support for billed units
- CPT 97155: documentation of protocol modification
- CPT 97156: caregiver guidance documentation
- Authorization periods, rendering-provider eligibility, and overlapping service time
These are not universal CPT requirements. Actual expectations depend on applicable coding guidance, payer policies, contracts, state rules, and the services rendered. We also support mental health, therapy, and other healthcare organizations through tailored operational reviews.
A preliminary reflection
The Capri Compliance Exposure Explorer
This is a preliminary reflection tool, not an audit or formal risk assessment. It does not generate a compliance score, does not determine whether your organization is compliant, and does not make legal conclusions. Please do not include patient information. Selections stay in your browser until you submit an inquiry.
Our approach
From Findings to Stronger Operations.
01
Assess
Understand the organization, identify concerns, and establish a tailored review scope.
02
Investigate
Review selected documentation, claims, systems, policies, and workflows to identify patterns and potential root causes.
03
Recommend
Present prioritized findings, operational risks, corrective actions, and recommended ownership.
04
Implement & Strengthen
Where included in the engagement, support staff training, workflow changes, system improvements, and ongoing internal monitoring.
Assessment and implementation may be separately scoped. Not every engagement includes every stage or service.
Ways to work together
The Right Scope for Your Situation.
Compliance & Risk Assessment
Proactive, scoped examination of operational controls and potential exposure.
Documentation & Claims Review
Targeted review of documentation, billing support, templates, and reconciliation practices.
Audit Response & Corrective Action Support
Operational preparation, coordination, remediation planning, and implementation support for organizations facing payer scrutiny.
Ongoing Compliance Operations
Recurring internal monitoring, staff education, workflow oversight, and process improvement.
All engagements are quoted individually following a consultation.
Connected expertise
When the Assessment Reveals a Bigger Operational Issue
Some findings point to a broader operational cause. The right next step depends on your organization—not every service is needed for every client.
Revenue Cycle Management
For denial patterns, documentation-to-claim reconciliation, and revenue-cycle controls.
Practice Operations & Consulting
For disconnected handoffs, unclear accountability, and recurring workflow gaps.
Credentialing & Payer Contracting
For provider enrollment, qualifications, and payer participation issues.
Technology & EHR Implementation
For templates, system configuration, reporting, and internal checks.
Operational Turnaround & Restructuring
For broader operational instability, restructuring, and financial pressure.
Clinical & Operational Excellence
For clinical-operational alignment, documentation workflows, and staff development.
Confidential inquiry
Let's Find the Gaps—and Build Better Systems Around Them.
Tell us what prompted your concern. We’ll discuss a tailored review and the operational support that may be useful.
Capri provides operational consulting and documentation reviews—not formal independent audits, legal representation, or certified coding opinions. Specialist matters require appropriately qualified professionals. Payer audit outcomes are not guaranteed.