56.47% 01
of 241,750 appealed Medicare Advantage post-acute terminations reviewed in 2025 where QIO physicians disagreed with the plan.
Medicare Advantage coverage support for skilled nursing
Every covered day, accounted for.
Daybook helps your team spot questionable terminations, assemble the supporting clinical record, and track every outcome—before covered days turn into write-offs.
- No integration
- BAA before identifiable data
- 10-business-day return
Sample coverage audit Illustrative resident data
✓
Every finding traced Quote, document, and page included
Why this matters
Coverage turns on the record—and the clock.
When a plan ends coverage, your team has little time to answer. Daybook helps put the relevant clinical evidence and notice history in order before the deadline drives the decision.
Day 15 02
where termination notices clustered in Acentra’s focused study, without consistently tracking documented progress.
≈ 1 hour 03
the operational upload window Acentra asks facilities to meet when requesting the record for expedited review.
These are large-scale review signals, not a promise of results: 56.47% describes appealed cases in Acentra’s 29-state service area, not the unappealed population. The one-hour window is QIO operating practice, not a statutory deadline. Your audit shows what is happening in your own facilities.
The coverage gap
The appeal is not won by a better paragraph. It is won by a ready record.
The notice arrives. The evidence is still scattered.
Therapy goals, skilled-nursing rationale, discharge risk, notice delivery, and plan criteria live in different documents and systems.
Clinical and business-office teams scramble under the clock.
Time goes to finding notes, reconciling dates, and rebuilding the story instead of deciding what action the case deserves.
The decision is logged, but the lesson is lost.
Nobody can see which plans, criteria, documentation gaps, or facilities are repeatedly costing covered days.
What you receive
Everything needed to decide where to act.
Review the same format your team receives: a prioritized coverage audit for leadership and a cited evidence packet for case-level review. The examples use illustrative resident data.
Illustrative sample 01 / Coverage audit
See which cases deserve attention first.
A ranked view of coverage events, estimated value at issue, notice problems, supporting evidence, and recurring gaps across your facilities.
Open sample audit PDF
Illustrative sample 02 / Evidence packet
Give the reviewer a clear, cited case.
The relevant deadline, notice findings, dated clinical timeline, skilled-need evidence, missing information, and a concise reviewer brief.
Open sample packet PDFA simple starting point
Start with the last 90 days. Decide from your own numbers.
Daybook does the review and packet preparation. Your team does not need to implement a new system or add another queue to manage.
- 01 Share
Securely share the last 90 days.
NOMNCs, denial letters, outcomes, and the supporting records for affected stays. No integration and no patient information through this site or ordinary email.
- 02 Review
Receive the audit in ten business days.
Daybook reviews the cases, checks the supporting record, prepares sample packets, and returns each finding with the evidence your team can inspect.
- 03 Decide
Continue only if the opportunity is worthwhile.
A fixed-fee pilot helps monitor new notices, prepare the evidence, keep deadlines visible, and track outcomes across participating facilities.
What your team can verify
Every finding comes with the evidence behind it.
Before your team acts, it can see what supports the finding, what is missing, which deadline applies, and who reviewed the packet.
Read the security and review practicesTraceable clinical support
Each clinical finding includes the exact quote, document, and page.
Reviewed before use
A named person reviews each packet before your team receives it.
Deadlines you can verify
Every due date shows the notice date, applicable rule, and basis.
Clear appeal roles
Beneficiary review rights and provider payment appeals stay distinct.
The first move
Ninety days of files. One honest answer.
If the audit finds recoverable or protectable value, you will see exactly where it is. If it finds nothing, you will know your current process held up.
- One secure historical file pull
- Ten-business-day turnaround
- No integration and no committed spend
- Sample packets included
Coverage audit request No charge
Daniel Voigt · Founder Built by an operator
Healthcare systems experience behind the work.
Daniel Voigt is a former healthcare CTO who built and led an enterprise EHR and revenue-cycle platform through its acquisition. His work spanned claims and remittance processing, reimbursement, and the financial reporting healthcare CFOs rely on. Daybook applies that experience to the Medicare Advantage coverage work skilled nursing teams are asked to manage under pressure.
Why Daybook existsCommon questions
What operators ask before they share a file.
Do we need an EHR integration?
No. We start with the exports and documents your systems already produce. If you continue after the audit, secure scheduled exports are enough to begin.
What exactly do we receive from the free audit?
A ranked review of recent Medicare Advantage coverage events: which cases deserve attention, why they stand out, the estimated value at issue, notice problems, recurring documentation gaps, and sample evidence packets for the strongest cases.
Who files an expedited termination appeal?
The beneficiary or their authorized representative. Daybook prepares the facility-controlled evidence, validity findings, deadline summary, and cited packet. Provider payment appeals remain a separate lane. Nothing is filed on anyone’s behalf without proper authorization.
How is identifiable information handled?
Not through this website and never by ordinary email. Identifiable files are accepted only after the engagement’s BAA is in place and through an access-controlled upload channel. De-identified samples are welcome for the first conversation.
Is AI making clinical judgments?
No. Daybook organizes the record and prepares the work for review. Your team can see the exact quote, document, and page behind every clinical finding, and a named person reviews each packet before it is used.
What does a pilot cost?
The audit is free. If it shows a worthwhile opportunity, the next step is a fixed-fee pilot over a defined group of facilities — a flat price agreed up front, not a percentage of what is recovered. Ongoing pricing is a per-facility subscription sized against the value your own audit demonstrates.
Primary sources behind the public statistics
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Acentra Health BFCC-QIO, Annual Medical Review Services Report CY2025: 241,750 MA post-acute termination appeals reviewed; physician reviewers disagreed with the plan in 56.47% of cases. Primary report ↗
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Acentra Health BFCC-QIO, CMS-approved focused study on Notices of Medicare Non-Coverage in post-acute care. Study summary ↗
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BFCC-QIO expedited-review operating procedures. The regulation places the burden of proof on the plan; Acentra operationally asks facilities to upload requested records on an approximately one-hour clock. Acentra webinar Q&A ↗
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HHS OIG OEI-09-24-00331 (June 2026). The widely reported 95% figure concerns appealed skilled-nursing-facility admission prior-authorization denials, not continued-stay terminations. HHS OIG report ↗