SKILLED NURSING
SNF analytics for referrals, PDPM and claims
SimpleCORE™ (formerly CORE Analytics) helps improve Medicare A referrals and optimize claims and triple-check processes
SimpleCORE™ – Real-time referral opportunities
Quickly optimize Medicare A referrals, claims revenue and triple-check processes.
Identify immediate revenue opportunities.
Quickly pinpoint billing inconsistencies and
PDPM opportunities using thousands of automated logic tests, so you can correct issues prior to claim submission.
Evaluate and reduce audit risk.
Pinpoint audit risk areas and devise strategies to ensure claims compliance. Quickly identify outliers and strengthen coding to ensure claims are accurate and complete.
Enhance Medicare A referrals and census
Use current claims and Medicare A data to evaluate and improve referrals and census in your SNF organization. Quantify Medicare Advantage performance and optimize rates.
Optimize triple-check processes.
Combine claims and MDS data to unlock the full potential of your data. Simplify your IDT/Triple-Check processes while ensure accurate coding and billing.
Unlock revenue using current claims data
SimpleCORE™ provides unmatched claims analytics power through these modules.
SimpleCORE™: Compliance.
Quantify third-party audit risk with our proprietary SALT (Statistical Analysis of Likely Targets) Report. Compare PDPM focus areas against the national database to drive internal auditing strategy.
SimpleCORE™: Reimbursement
Identify PDPM revenue opportunities with thousands of statistical logic tests for Medicare and Medicare Advantage — guaranteed to improve reimbursement.
SimpleCORE™: Value-Based Post-Acute eXchange (VBPAX)
Measure clinical and financial outcomes to demonstrate referral partner value. Benchmark claims against regional averages to qualitative data measures.
SimpleCORE™: Medicare Advantage Post-Acute eXchange (MAPAX)
Unlock insights previously known only to insurance companies. MAPAX delivers the industry’s first claims-based intelligence on current SNF-MA reimbursement, outcomes and value proposition.
We’re creating the SNF industry’s first real-time view of Claims + MDS + Staffing insights.
What clients love about SimpleCORE™
CORE is ingrained in every aspect of our Medicare and Managed Care process. From guiding triple-check to benchmarking performance to driving compliance auditing, we rely on CORE.
Before CORE, we had no idea how the rest of the industry was performing. Now, our Medicare reimbursement strategy is centered around CORE logic tests and PDPM benchmarking.
We operate across multiple post-acute care settings. CORE is imperative for us to quantify and demonstrate value as we enter into risk-based payment models.