Medicare Advantage plans authorize about seven days at a time. Every resident, every week, someone has to make the case again.
Twenty residents on Medicare Advantage means twenty write-ups a week, done by the DON or the business office manager.
When a submission goes out thin, coverage ends while the resident still needs care. Then it becomes an appeal.
Step three
They always own what goes out. Certesa produces a draft and nothing more. It does not send anything to a payer, and no document leaves your facility without a licensed clinician reading it and signing off.
Scale of the problem in Florida
27,257
Medicare Advantage post-acute appeals in Florida in 2025. Up 16 percent in one year.
Source: Acentra Health, BFCC-QIO Annual Medical Review Services Report, Reporting Year 2025, Region 4, Florida appendix. Acentra Health is the Medicare quality improvement organization for Florida.
Concurrent review justifications
Weekly continued-stay documentation.
Denial appeals
Written against the plan's stated reason.
Authorization tracking
What expires, and when, per resident.
Peer-to-peer preparation
The record summarized before the call.
Call or write, and we will sit down with your DON and walk through a real week of authorizations.
Certesa started with a family of physical therapists in South Florida, where patient care and the paperwork behind it were never far apart. Continued-stay documentation is a recurring problem in these buildings, and a solvable one. With Medicare Advantage, it is now also a weekly one.
In most of these cases the care is not what is in question. The write-up is.
Continued-stay authorization is the work that slips when a building is short-staffed.
It falls to one person, usually late in the day, re-reading a chart they already know and retyping the same clinical story for the fifth time that week. The facts that support the stay are already in the record. Getting them onto the page is the work.
Certesa does that writing. It does not make clinical judgments and it does not decide what is medically necessary. A clinician does that, the same as before.
Protected health information, handled as such.
A clinician reviews and submits every document. Certesa never submits anything to a payer.
Miami, Florida. We work with facilities across South Florida and we are glad to come to the building. Most first conversations happen in person, at your conference table, with a real week of authorizations in front of us.
Synthetic sample data. Not for clinical use. No patient information is stored.
This is the authorization tracker with synthetic residents. Open the resident whose authorization expires in two days, and Certesa drafts the justification from the chart already on file.
Start with the resident expiring in 2 days
{{ residentMeta }}
{{ authLine }}
{{ sourceMeta }}
{{ chart }}
Received 09/10 · UnitedHealthcare AARP · Auth 4417-22
{{ denial }}
Evidence pulled from the record
The chart is loaded on the left. Press {{ generateLabel }} to see the document Certesa prepares for clinician review.
Certesa
Certesa drafts. A licensed clinician reviews and submits.