Industry Friction Checklist
Check every statement that describes your agency's reality. Be honest — this is for your benefit, not ours.
Documentation & Care Records
DSPs regularly complete notes after the shift ends — sometimes the next day
We've had claims denied because documentation didn't support the service billed
During our last audit, we scrambled to find records that should have been on file
Our paper or PDF notes lack consistency — different DSPs write very different things
Billing & Revenue
We've experienced claim denials we could have prevented with better documentation
Our billing team spends significant time correcting errors before submission
We're not confident our billed hours match our authorized hours every month
We've had to repay Medicaid funds due to documentation or billing errors
Scheduling & Workforce
Scheduling changes happen via text or phone calls — nothing is tracked centrally
We sometimes schedule staff for hours that aren't authorized
DSP turnover is high and we think admin burden is part of the reason
Onboarding new DSPs takes longer than it should because of paperwork
Compliance & Audit Readiness
We would not feel confident if HCPF announced an audit this week
Our incident reports aren't always filed within required timeframes
Staff training certifications are tracked in spreadsheets or paper files
We have no single place to see the compliance status of all clients at once
Technology & Operations
We use 3 or more separate systems that don't talk to each other
Our EHR or current software wasn't built specifically for HCBS/IDD services
0 /18
Your Score
0–4 checked: Well-managed. 5–9: Real gaps worth addressing. 10+: Urgent — let's talk today.
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