Revenue integrity

Get paid for the care you provide, and keep it.

Every dollar in a skilled nursing facility depends on something documented in the chart. Veridence connects coverage, clinical documentation and payment, so claims go out complete and payments come back correct.

Dailycoverage and benefit day tracking
Month endTriple Check prepared from the record
Every claimchecked before it goes out
Every paymentcompared to what was expected
Triple Check

Month-end Triple Check, prepared before the meeting.

Veridence assembles the Triple Check from your records, so the meeting is spent resolving exceptions rather than finding them.

  • MDS, orders and billing lined up by resident
  • Missing physician certifications and signatures
  • Therapy documentation checked against the census
  • Sign-off recorded for every reviewer
Triple Checklive
September
ItemWhereStatus
Physician certifications24 of 262 missing
MDS and billing match38 of 38Ready
Therapy documentation31 of 321 to review
Coverage verifiedAll residentsReady
Sample data3 exceptions
Medicare Advantage

Authorizations and concurrent review, on time.

Know when each authorization ends and have the clinical justification ready before the plan asks for it.

  • Authorization end dates for every resident
  • Clinical documentation assembled for concurrent review
  • Denials tracked and ready for appeal
  • Coverage and benefit days by payer
Across the revenue cycle

Across the revenue cycle

Coverage and eligibility

Who is paying for each day, benefit days remaining and verification status.

Expected payment

What each day should pay under PDPM, compared with what was paid.

Claim readiness

Claims checked for documentation gaps before they are billed.

Payment variance

Remittances compared with expected payment, with underpayments listed.

Overpayment obligations

Identified overpayments tracked against their reporting deadlines.

Case-mix review

A regular look at your coding patterns, before a reviewer takes one.

How it works

From the record to your team.

01

Coverage confirmed

At admission and at each milestone after.

02

Care documented

In the chart, as it happens.

03

Claim checked

Against the documentation before it is billed.

04

Payment reconciled

Against what the day should have paid.

Questions

About revenue integrity.

Does Veridence submit claims?
No. Veridence works alongside your billing system. It makes sure each claim is supported by the record and that each payment is correct.
Is revenue integrity available over our current EHR?
Triple Check, audit defense and authorizations are included in compliance mode. The full revenue suite is part of the complete record edition.
Does it cover Medicaid?
Yes. Coverage, eligibility and payer tracking include Medicaid and Medicaid managed care.
Keep exploring

More of the platform

See your facility the way a surveyor will.

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.