Veridence writes the institutional claim from the same chart, MDS and coverage record your team already keeps, then follows it until it is paid. A claim with anything missing is held with the reason, never sent.
Every claim is checked against the billing profile, the coverage, the charges and the MDS before it is written. What is missing is named, with who fixes it.
| Item | Where | Status |
|---|---|---|
| Medicare Part A, 14 claims | Built | Ready to release |
| Medicare Advantage, 6 claims | Held | Authorization |
| Medicaid, 22 claims | Built | Ready to release |
| Private pay, 3 claims | Held | Missing charge |
Acknowledgements, status responses and payments are read back against each claim, so a claim nobody has heard about is flagged as silent rather than shown as in process.
Coverage checked with the payer before and during the stay. The response is evidence; a person verifies it.
Medicare Advantage requests and the plan's answer, recorded against the resident's coverage.
Charges, payments and statements for each resident, with adjustments approved by a second person.
The residents' own money kept separate from the facility's account, and never used as a payment.
Coverage, MDS and charges are checked for every resident.
Complete claims are written; incomplete ones are held with the reason.
A person reviews and releases each file.
Payments are read back and matched, claim by claim.
A short screen share with our team. We will walk through the daily view, a mock survey and month-end Triple Check, using sample data.
