Clean Claims

Sandata Clean Claims: Proactively ensure payment accuracy and say goodbye to “pay and chase”

Having Clean Claims is essential to ensuring payment accuracy and driving efficiency in homecare delivery. It has a positive impact on every aspect of homecare operations, from payment integrity and regulatory compliance to provider relationships and operational efficiency. Sandata Clean Claims gives you an effective way to validate EVV claims pre-adjudication, enabling significantly lower claim denial rates and reconciliation costs as well as higher first-pass payments.

Accuracy. Efficiency. Compliance.

Pre-Adjudication Authorization

Say goodbye to “pay and chase.” Sandata’s Clean Claims solution leverages an enhanced claims editing process to validate homecare claims against EVV data before those claims are adjudicated, significantly reducing the need for subsequent recovery expenses.

Cost Savings

Sandata Clean Claims validates homecare claims against EVV data in a pre-adjudication mode and before claims are received and processed by payers. This contributes to lower claim denial rates and reconciliation costs, as well as higher claim auto adjudication and first-pass rates.

Better Provider Relations

Sandata Clean Claims integrates existing EVV, claim, and payment systems and industry standard
EDI formats and allows providers to continue to work with their vendors of choice, thereby significantly reducing provider abrasion.

An Out-of-the-Box Solution

Sandata’s Open Model enables integration with the provider’s existing solutions, and integrating our Clean Claims solution is a lower technical lift to implement in comparison with trying to build it internally. And, it eliminates the need for any respective technical maintenance.

Clean Claims

  • Select the most suitable tools and services for unique needs
  • Reduce friction caused by using multiple incompatible systems
  • Streamline data exchange and care coordination, which is essential in today’s complex healthcare environment

Supporting Services

Fuse™ Agency Management

This next-level agency management solution blends best practices learned from supporting 20,000+ agencies with a sleek, reliable, user-friendly interface and intuitive, impactful interactions for an unparalleled agency experience.

  • Improve cash flow and reduce friction with a billing module that includes multi-payer claims submissions with a single click
  • Leverage AI for shift booking to improve workforce optimization and save valuable time
  • Meet care coordination goals with our enhanced clinical platform
  • Improve data accuracy, scalability, communication, and compliance with advanced integrations
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What Our Customers Are Saying

“Before Sandata, we were validating EVV to claims post-adjudication and playing ‘pay and chase.’ We’ve since reduced our claim denial rates and reconciliation costs, as well as having much higher claim auto-adjudication and first-pass rates.”

Related Resources


Value-Based Care and Revenue Cycle Management

What is value-based care, and what does it mean for your agency? In short, value-based care focuses on creating positive patient outcomes rather than fee-for-service reimbursement. The goal is to be proactive, rather than reactive, and reward providers for helping patients become healthier—not just treat conditions after they occur.


Tips and Tricks for Revenue Cycle Management Success for Providers

Providing the best care possible to your clients is your main priority as a homecare or I/DD provider, but operating within the industry can provide distractions that inevitably shift your focus away from your clients.


The “Ins and Outs” of Insourcing vs. Outsourcing Revenue Cycle Management: Part 1 – Outsourcing Decision Impactors

The revenue cycle – the series of steps related to reimbursement for services that occur from intake to payment – is the lifeblood of any homecare or I/DD agency. You can provide the best client support with excellent outcomes and grow like a weed, but with the thin margins we experience today, your agency will struggle if you don’t collect almost 100% of the revenue to which you are entitled.

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