Attest

For home health & hospice agencies

Attest turns the fax pile and the OASIS form into a draft your clinician signs.

Your nurses chart OASIS for an hour or two per assessment, often at home at night. Your coordinator keys patient data off a faxed referral while the agency down the street admits first. Attest fits your HCHB, Axxess, or WellSky stack, finds the one or two assists with the clearest payback, scopes the HIPAA and audit risk before go-live, and stands up the review workflow so a licensed clinician signs everything. There is no auto-file path near a chart. Done with you, from $499/mo.

8 min read

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The shift

The big EHRs just shipped AI inside the system of record — WellSky launched Scribe and the WILA voice assistant for OASIS, and Homecare Homebase rolled out its Intelligence Suite with Intake Central and Predict. The tools exist. The wave hasn't reached the small-agency floor, because someone still has to fit it, scope it, and run the human-review workflow. That's the gap Attest closes.

Your reality

This is a Medicare and Medicaid-reimbursed, heavily regulated clinical vertical. Every OASIS field, CTI narrative, visit note, and claim is a document a surveyor or auditor will read. Home-health margins look healthy (about 20% Medicare FFS in 2023) but CMS keeps clawing them back — the CY2026 final rule cuts aggregate home-health payments 1.3%. You're running faster to stand still. What sells here isn't a chatbot; it's paperwork relief and audit-ready documentation, with a licensed human always signing off.

100+

OASIS-E fields per start of care

~1 in 5

after-hours referrals missed

45 → 10 min

referral response, vendor-reported

$499/mo

done with you, from

Fits the stack you already run

Homecare HomebaseAxxessWellSkyOASIS-EPDGMEVV

Sound familiar?

My best nurse is charting at 10pm again — OASIS-E runs 100+ fields per start of care, and much of it gets done off-the-clock at home.
The referral came in at 6pm and we found out Monday — and roughly one in five after-hours referrals gets missed entirely.
I don't sleep the week before a survey — Plan of Care, Medications, Infection Control, and missing face-to-face are the citations I can't catch in time.
We did the work and the claim came back denied — most of what trips us up is documentation, not care.
One audit could claw back claims we already got paid for — UPIC, TPE, and SMRC reviews keep expanding, and hospice decline narratives are the trigger.

Where AI fits

Turn the fax pile into a structured intake draft

Stop losing the 6pm referral to the agency that called back first.

Attest reads the faxed or emailed referral packet, extracts demographics, diagnosis, referring physician, and insurance into a structured intake draft, flags the missing fields, and pre-checks eligibility around the clock.

Fewer missed after-hours referrals
Faster start of care
Less keying off a fax

Watch for: The coordinator reviews the extracted record · Eligibility is confirmed before admission · Attest never admits a patient

Best for: Any agency taking referrals by fax or phone where after-hours leakage is real money.

Give your nurses their evenings back

An ambient scribe drafts the assessment so the RN opens a populated form, not a blank one.

Attest captures the visit conversation and the structured assessment, then pre-populates the 100+ OASIS-E fields and the visit narrative for the nurse to review and finish.

Less charting at home
A real retention lever
The same record, faster

Watch for: The RN edits and signs every field · OASIS scoring drives PDGM payment and gets audited · Nothing is final without clinician sign-off

Best for: Agencies where charting-at-night burnout is driving the turnover that costs a fortune to backfill.

Close the gap to the first billable visit

Tighten the stretch between referral accepted and start-of-care visit.

Once a referral is accepted, Attest drafts the eligibility check, proposes a visit slot that matches clinician skill and geography, and queues the authorization request — pausing at an approval gate between every step.

Tighter revenue cycle
Fewer visits slipping past 48 hours
Less manual relay

Watch for: The scheduler approves the clinician and slot · The coordinator confirms authorization · The workflow proposes; people commit

Best for: Agencies where about a third of patients aren't seen within 48 hours of discharge and the revenue cycle pays for it.

Be survey-ready every day, not just survey week

Catch the predictable deficiencies before a surveyor or auditor does.

Attest runs across your chart set and flags records missing a face-to-face, untimely physician signatures, or OASIS functional scores that conflict with the visit notes, then hands your QA nurse a prioritized remediation worklist.

Fewer survey surprises
Fewer denials from OASIS-vs-note gaps
Audit exposure caught early

Watch for: The compliance nurse reviews each flag · The nurse decides every fix · Attest flags but never edits the record

Best for: Owners who lose sleep over UPIC, TPE, or SMRC clawbacks and missing-F2F citations.

Answer a documentation question with the rule attached

Settle "what does the CTI narrative need to say for benefit period 3?" with a citation, not a binder hunt.

Attest runs a grounded search across your own policies, the CMS Conditions of Participation, and the relevant Local Coverage Determinations, returning an answer with linked sources back to the rule.

Faster answers
Grounded in the actual regulation
Less binder-flipping mid-visit

Watch for: Answers are advisory, with linked sources · The clinician confirms against the cited rule · Eligibility stays a physician determination

Best for: Agencies where coders and nurses burn time hunting CoP, LCD, and policy requirements.

Keep referral relationships warm on a real cadence

Stop letting a discharge planner's referral go un-thanked.

Referral activity drives a follow-up queue: Attest flags new sources to thank and dormant practices to re-engage, then drafts on-voice outreach for the liaison to review and send.

Referral relationships kept warm
Dormant sources re-engaged
Leakage treated as a process, not luck

Watch for: The liaison approves each outreach before it sends · No PHI goes into marketing content · Tone stays on your voice

Best for: Agencies whose admissions depend on a handful of hospitals, SNFs, and physician offices.

Safe to start vs. proceed with guardrails

Safe to start now

Drafting referral-intake records from a faxed packet for a coordinator to confirm.
Ambient scribe drafting OASIS fields and visit narratives for the RN to edit and sign.
Grounded policy, CoP, and LCD search that returns answers with citations a nurse verifies.
Survey-readiness flagging that produces a worklist — flags only, no chart edits.
Referral-source follow-up drafts the liaison reviews before sending.
Drafting routine, non-clinical family replies (visit times, what to expect) for staff review.

Proceed with guardrails

Anything touching an OASIS field that bills — it drives PDGM payment and is audited, so the RN signs every field.
CTI narratives and hospice eligibility — a medical-legal call the certifying physician writes and signs, never the AI.
PHI on field devices — endpoint encryption, secure messaging (not SMS), and audit logging get scoped before go-live.
EVV-linked visit records — the Cures Act mandates EVV and rules vary by state, so automation must respect each state's requirements.
Any claim before it's filed — nothing files without a human check on F2F, homebound, NOA timing, and OASIS-vs-note consistency.
Anything a family or surveyor could see — keep AI to back-office paperwork, with transparency as the default.

Why do it with us

Hire a consultant	A discovery deck and a high hourly	You still build and run it under HIPAA
Hire an AI engineer	A salary hard to justify under a 100 census	They don't know OASIS, CTI, or what a surveyor cites
DIY on nights and weekends	No new line item	Abandoned by week two, on top of the survey and the schedule
Attest, by systemlevel.ai	Done with you, from $499/mo	One senior operator fits, scopes, and stays accountable for the number

WellSky Scribe at one Pennsylvania agency reports roughly 50% documentation time savings and about 30 minutes saved per start-of-care visit — a vendor-reported figure.
A referral-intake rollout at one agency cut referral response time from 45 minutes to 10 minutes, again vendor-reported.
An independent JAMA study across five academic medical centers found ambient scribes cut documentation time by about 16 minutes — real, but smaller than the vendor headlines.
A peer-reviewed palliative-care pilot saw a significant time saving for one clinician and almost none for another — benefits are adoption-dependent, not automatic.
So we promise measurement — your number, measured on your agency — not a fixed percentage.

Questions you’re probably asking

An AI mistake could cost a patient's safety, a survey deficiency, or a clawback.: That's the right fear in a vertical where every record gets read by a surveyor or auditor. It's exactly why Attest is built draft-and-review, never auto-file. A licensed clinician signs every OASIS field, every note, every CTI; Attest assembles and flags, humans decide. If an AI error would land in a surveyor's report, you have a human checkpoint above it.
Our data is protected health information — is this even HIPAA-safe?: PHI exposure is amplified here because records travel on field devices, and the most common violation is staff using non-secure channels like SMS or personal email. We scope security, vendor, and BAA requirements before go-live — endpoint encryption, secure messaging, audit logging, no PHI in the wrong tool. Compliance is a go-live gate, not an afterthought.
My nurses are already drowning in tech — another system is more burden, not less.: The top named barrier to AI here is integrating multiple systems and training employees, and that's the opposite of what we do. Attest is done-with-you: we fit it to your existing HCHB, Axxess, or WellSky stack, train your team, and own the rollout. Not another login — a workflow that fits the one you have.
We tried a scribe pilot and it didn't save the time they promised.: Believable — the peer-reviewed evidence shows wide clinician-to-clinician variance, and a self-serve tool dropped on a busy nurse gets abandoned by week two. That's why Attest is done-with-you, with measurement and iteration built in, not a login we hand you and walk away from.
Families won't trust AI in end-of-life care.: Trust collapses when AI influences care behind the scenes and is only revealed after a problem. So Attest stays on paperwork and the back office — never bedside judgment. The clinician relationship is untouched, the human path is always preserved, and transparency is the default.

Pricing

Operator — $499/mo

Monthly strategy, your first workflows mapped and scoped, a stack assessment, vendor and model recommendations fit to your HCHB, Axxess, or WellSky stack, and email support.

Best for: Scoping intake automation or denial reduction and seeing the math before you commit.

Flagship — $999/mo

Everything in Operator, plus bi-weekly working sessions, implementation guidance through deployment, architecture and integration review, team training and prompt libraries, and a direct line for unblocking.

Best for: Agencies ready to stand up the review-backed scribe or the survey-readiness sweep across the floor.