Sandata Claims Validation: Improve Payment Accuracy and Reduce Provider Abrasion

Sandata has long championed the open Electronic Visit Verification (EVV) model. This way, providers can choose to use their own EVV system or use the state-supplied EVV system.

Sandata also championed the Open Billing model, where providers can continue to use their current claims process while still confirming EVV data to validate the claims prior to payment.

These two models set Sandata apart from the competition, enabling states to avoid payment of unauthorized or unapproved services for claims while minimizing provider abrasion.

• Clear Responses
  Standard adjudication responses make interpreting the results easy and fast.

• Flexible Interface
  Works on your claims payment schedule with your tools and your rules. Can be used as a real-time web interface, a batch process, within existing adjudication, or standalone.
• Extensive Experience
  Sandata has extensive claims validation experience and works with each provider to ensure: a claims matching process and timing that works best for your stakeholders and EVV program, providers have access to claims matching results and reporting, the claims matching process supports CMS Certification and KPI reporting requirements, and program requirements are met by sharing our experience in communicating claims matching results to the provider community.

Learn more about Claims Validation.