MCO

Payer Solutions for
Managed Care Organizations

Sandata MCO

Are your payer solutions working for you, or against you? 

Sandata Payer Solutions are Software as a Service (Saas) systems. Each component works seamlessly to integrate and ease communication, drive accountability, and optimize care for your members. Specifically designed to support payer needs, including 21st Century Cures Electronic Visit Verification™ (EVV) compliance, it will:

  • Improve workforce management and efficiency
  • Aggregate program data into a single environment for oversight, compliance, and reporting
  • Improve communication between all stakeholders
  • Ensure you only pay for care that was actually delivered
  • Monitor key program trends, outliers, and provider performance across your entire program

What does an end-to-end solution for MCOs look like? It’s an automated flow of data from the home care order to billing. Its timely delivery of care. And its assurance that you only pay for care that was delivered. Find your way to more profitability, better quality of care, and confidence in your providers’ compliance.

With Sandata Payer Solutions, your organization can expect to benefit from:

E

Order Manager

Provides direct communication of orders and care plans to your providers facilitating secure communication, order tracking denial/acceptance, and measuring the compliance of care.

E

EVV Portals

EVV portals allow you to view visit data through an easy-to-use user interface to monitor activity and make visit capture corrections as required.

E

Aggregator Portal

Sandata’s Aggregator minimizes friction by allowing providers to use EVV and billing systems of their choice while ensuring all program data meets Payers’ rules. Payers use the Aggregator portal to monitor the overall EVV program.

E

Visit Capture EVV

Sandata offers multiple EVV technologies to ensure real-time home and community-based visit data and verification is always available and captured at the point of care.

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Claims Validation

Ensures you only pay claims for services that were actually delivered to your members, regardless of which system the provider uses.

E

Oversight and Analytics

Sandata provides robust business intelligence tools, including flexible dashboards and ad hoc reports, to allow payers to easily monitor all HCBS service delivery and readily detect potential fraud, waste, and abuse.

With over 40 years supporting provider agencies across the country, Sandata brings the experience, innovation, and customer-centric approach that makes it possible for agencies to get more right from the start.

Making it Easier From Day One

Sandata’s software and services are designed to make it as simple as possible for payers and providers to work together, achieving operational efficiencies and increasing compliance, while also ensuring patients receive the highest quality of care possible by streamlining internal processes and software systems.

Step 1

Work with the Sandata team to design the right solution for your organization.

Step 2

Deploy the Sandata solution and train with our experienced team.

Step 3

Enjoy the easier process of payers and providers working together.

Here’s How it Works for Managed Care Organizations

MCO’s are facing many challenges: the complexities of Medicaid, shrinking margins, outdated processes, keeping patients safe and in their homes, and so much more. Sandata’s solution for MCO’s enables you to integrate processes and streamline workflows, reducing the friction between you and your providers. Our end-to-end software has helped more than 50 MCO’s in 18 states improve processes, manage costs, and provide program analytics to understand and fix the challenges they face in the complex healthcare system.

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Sandata Launches Face and Fingerprint Identification

Sandata Launches Face and Fingerprint Identification

Sandata is pleased to announce face and fingerprint identification as a new feature in its Sandata Mobile Connect® (SMC) app, used by its home care provider network. This update allows users to more easily log into SMC securely.   Ken Faltischek, Chief Operating...

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It’s getting EVV from the people who invented EVV.