A signed CTI doesn't protect an agency if the medical record doesn't support the terminal prognosis behind it. With CMS prepayment review activity expanding, reviewers are reading the whole chart, not just the form.
In this targeted session, Maxwell TEC Senior Consultant Keri Shockley helps you go beyond basic CTI completion to ask whether each certification is compliant, individualized, clinically supported, and defensible.
You'll see how a strong physician narrative compares to a weak one; how to keep the CTI, face-to-face encounter, and clinical notes telling the same story; and how to document continued eligibility for long-stay patients.
Key Takeaways:
- Know the requirements and where they break down: Understand core CTI and recertification rules, and the timing, signature, narrative, and face-to-face deficiencies that put payment at risk.
- Tell a complete CTI from a defensible one: Recognize the documentation patterns that raise audit and denial risk, including generic narratives, contradictions, and repetitive "stable" entries.
- Connect the CTI to the full clinical record: Align it with admission assessments, face-to-face findings, IDG documentation, functional measures, nutrition, symptom burden, and disease progression, and apply a reviewer mindset to long length-of-stay and later-benefit-period patients.
- Build workflow controls that hold up: Put CTI ownership, recertification tracking, QA review, escalation, and pre-bill validation in place.