Authorize services in units with effective dates, payer, and HCPCS codes. Utilized units derive automatically from delivered services so there is no manual tallying. Frequency caps are enforced per period, every amendment is versioned, and every change is auditable across HCBS, nursing facility, and ICF/IID programs.
From Approved Units to Delivered Services, Fully Reconciled
Service authorizations connect directly to the service catalog, the service plan, and the delivery record, so coordinators, billers, and auditors always work from the same numbers.
One Catalog. Consistent Rates. No Re-keying.
A shared organization service catalog with HCPCS codes, procedure codes, and rates drives consistency from authorization through billing, with reconciliation against service-plan interventions and delivered services.
Frequently asked questions
How does CertifyMed track utilized units?+
Utilized units are derived automatically from delivered services logged in the platform. There is no manual tallying: as services are delivered and recorded, the consumption ledger updates the utilized count against each authorization, giving coordinators a live view of remaining units.
What happens when an authorization is amended or superseded?+
CertifyMed versions every authorization. When an authorization is amended, the prior version is retained and marked superseded, never deleted. The full amendment history is auditable, and the active version always reflects the current approved units, dates, and payer.
Can I delete an authorization that was issued in error?+
No. CertifyMed uses a Void action rather than deletion. Voided authorizations remain in the record with a tamper-evident audit entry, preserving the billing and compliance history that payers and state auditors require.
One Platform. Every Module You Need.
Twelve integrated modules that replace scattered tools, spreadsheets, and paper binders - so you can focus on your clients, not your compliance gaps.
Assessments & Screening
InterRAI engine plus 14 validated screening tools. Scored automatically with clinical bands and safety protocols.
Service Planning
Person-centered service plans auto-populated from assessments. CMS 42 CFR §441.725 compliant.
Sessions & Telehealth
Video, audio, chat, in-person consultations with recording, live transcription, and scheduling.
HCBS Settings Compliance
CHCS compliance scoring (0-100) across 6 modules for 90+ setting types.
Incident Reporting
9 categories, 34 subcategories, automated severity scoring, and 5-stage investigation workflow.
Workforce Compliance
Staff credentials, expiration alerts, payer enrollment, and OIG/SAM exclusion monitoring.
Compliance Dashboard
One view of all compliance areas with priority action items and per-module health cards.
Organization Management
Client registry, team management, roles & permissions, and 10-tab client profiles.
Client Portal
Clients view their own care plan, appointments, and care team with restricted access.
Platform & Security
HIPAA compliant, end-to-end encryption, multi-role architecture, 2FA, and AI integration roadmap.
Service Authorization & Billing
Authorize services in units, track utilization automatically, enforce frequency caps, and keep every change auditable.
Electronic Visit Verification
Integrate with state EVV aggregators and reconcile verified visits against authorizations and units. Cures Act ready.
Assessments & Screening
InterRAI engine plus 14 validated screening tools. Scored automatically with clinical bands and safety protocols.
Service Planning
Person-centered service plans auto-populated from assessments. CMS 42 CFR §441.725 compliant.
Sessions & Telehealth
Video, audio, chat, in-person consultations with recording, live transcription, and scheduling.
HCBS Settings Compliance
CHCS compliance scoring (0-100) across 6 modules for 90+ setting types.
Incident Reporting
9 categories, 34 subcategories, automated severity scoring, and 5-stage investigation workflow.
Workforce Compliance
Staff credentials, expiration alerts, payer enrollment, and OIG/SAM exclusion monitoring.
Compliance Dashboard
One view of all compliance areas with priority action items and per-module health cards.
Organization Management
Client registry, team management, roles & permissions, and 10-tab client profiles.
Client Portal
Clients view their own care plan, appointments, and care team with restricted access.
Platform & Security
HIPAA compliant, end-to-end encryption, multi-role architecture, 2FA, and AI integration roadmap.
Service Authorization & Billing
Authorize services in units, track utilization automatically, enforce frequency caps, and keep every change auditable.
Electronic Visit Verification
Integrate with state EVV aggregators and reconcile verified visits against authorizations and units. Cures Act ready.
Walk into your next survey ready.
See how state agencies, MCOs, and provider networks run assessment, care planning, and continuous compliance on one platform.
