How does SeniorCRE run the SNF triple-check meeting so claims go out clean the first time?
Triple-check is the weekly ritual every SNF business office runs before Medicare and managed-care claims drop. On a fragmented stack, the MDS coordinator, the biller, and the DON each bring their own spreadsheet, the meeting takes 90 minutes, and the team still discovers a missing physician certification two days after the claim has been submitted.
Detail
Triple-check runs from one screen. Each claim in the upcoming bill cycle shows the supporting MDS (with lock status and ARD), the HIPPS code with PDPM component breakdown, the physician certification and recertification, the orders on file, the eligibility verification result, and the documented therapy minutes. Exceptions surface as actionable tasks — missing recert, expired auth, eligibility-and-billing mismatch — owned by name before the meeting starts. The meeting becomes review, not discovery.
Triple-check meetings compress from 90 minutes to 30. Clean-claim rate at submission improves, and the denials that previously came back two weeks later for missing documentation drop because the documentation gap was caught before the claim left the building.
Key points
- Paper triple-check binder
- Cross-team email thread before billing window closes
Key points
- HL7 v2 / FHIR R4 clinical feeds
- Flat-file EHR extracts
https://seniorcre.com/workflows/financial/triple-check-pre-billing