Veridian Public
Verification Operations Platform

Technology That Supports Operations and Existing State Systems.

The Veridian Public platform coordinates verification activities, beneficiary engagement, and case resolution — designed to complement the state systems already in place, integrate cleanly with prime contractors, and keep humans in the loop on sensitive decisions.

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Veridian Public Platform Stack A layered architecture stack showing the Veridian Public platform sitting between the engagement layer at the top and state systems of record at the bottom, with API endpoints connecting on the right side. LAYER 1 Engagement & Outreach Mail · SMS · Voice · Email · Portal · Kiosk LAYER 2 Verification & Evidence DMF · NCOA · Income · Residency · Identity attestation LAYER 3 Workflow & Case Routing Exception lanes · SLA timers · Worker queues · Audit trail LAYER 4 Integration & APIs REST · FHIR · SFTP · X12 · Webhooks · Event streams LAYER 5 State Systems of Record Eligibility · MMIS · Case management · Document store API ENDPOINTS REST · /verify FHIR · Patient SFTP · Batch X12 · 270/271 Webhook · Event DEPLOY Cloud · FedRAMP-ready On-prem · State-hosted Hybrid · Co-managed
Platform Capabilities

Five Platform Pillars. One Coordination Layer.

A coordination layer, not a system of record. Each pillar plugs into state Medicaid systems and the rest of the platform — without replacing them.

1Workflow Orchestration

Rules, queues, and case routing — configured to state policy, not the other way around.

The orchestration engine moves cases through their verification activities, applies state-specific business rules, balances queues by priority and skill, and times each step against the statutory SLA — with human-handoff checkpoints wherever the state retains the decision.

What's included

  • Configurable rule engine per state
  • Priority & exception queues
  • Skill-based routing
  • SLA timers with escalation
  • Human-handoff checkpoints
  • API hooks to state eligibility systems
RULE ENGINE PRIORITY STANDARD EXCEPTION SPECIALIST Human handoff
2AI-Assisted Outreach

AI drafts. Specialists review. The citizen receives a plain-language notice they actually understand.

AI inside the platform helps specialists draft, translate, and personalize beneficiary communications — never autonomously. Every outbound message passes through a specialist's review queue before it reaches a citizen. AI assists with speed and language; humans hold the decision.

What's included

  • AI-drafted plain-language notices
  • 12-language translation library
  • Per-citizen personalization variables
  • Specialist review queue & approve
  • No autonomous send to citizens
  • Bias & readability checks
AI DRAFT REVIEW Specialist APPROVED Send to citizen CITIZEN AI ASSISTS · SPECIALIST DECIDES
3Human-in-the-Loop Review

Sensitive cases never close on autopilot. Specialists review, decide, and document — with full context one click away.

The platform routes any case that touches a sensitive determination — eligibility flags, disputed evidence, hardship requests, language & accessibility accommodations — to a trained specialist with a unified case view. Every decision is logged with the reasoning attached.

What's included

  • Unified case view (evidence + history)
  • Sensitive-case routing rules
  • Specialist decision capture
  • Decision-reason taxonomy
  • Supervisor override & review
  • No autonomous eligibility decisions
FLAG CASE VIEW Citizen file Evidence ledger Outreach log Notes & rules SPECIALIST DECISION + reason CONTEXT · DECISION · REASON LOGGED
4Reporting & Audit Trail

Real-time dashboards for operations. Sealed audit packets for compliance. Same source data — one click apart.

Operations leaders see live volume, response rates, and SLA performance. Compliance leaders pull sealed audit packets that show every outreach attempt, every document, every decision, with timestamp and provenance. Same data, two presentations.

What's included

  • Live operations dashboard
  • SLA performance heatmap
  • Response rate by channel/language
  • Sealed per-case audit packets
  • Decision provenance log
  • Exportable for state & CMS review
OPS DASHBOARD VOLUME (24h) 12,840 +8.4% vs avg RESPONSE RATE 76.4% SMS leads SLA AT RISK 142 Specialist queue CASES CLOSED 9,612 96.1% on time SEAL AUDIT PACKET Same source · two presentations
5Integration & Security

Clean APIs for state systems. Role-based access for everyone. Encryption, audit logging, and least-privilege by default.

Veridian Public is a coordination layer, so integration is fundamental: REST, FHIR, SFTP, and X12 endpoints for state Medicaid systems and MES contractors. Every access is role-scoped, every change is logged, every transmission is encrypted — aligned to public-sector security expectations.

What's included

  • REST · FHIR · SFTP · X12 endpoints
  • Role-based access (state/county/Tribal)
  • Encryption at rest & in transit
  • Activity log for every action
  • FedRAMP-ready posture
  • Tribal sovereignty data protocols
VERIDIAN Coordination layer REST FHIR SFTP X12 ELIGIBILITY system MMIS claims DOC STORE records MES contractor
Where AI Helps

AI-Assisted, Not AI-Decided

AI inside the Veridian Public platform is used to assist trained specialists — drafting outreach text, translating content, summarizing case histories, surfacing next steps, and prioritizing queues. AI does not make eligibility determinations and does not act autonomously on sensitive cases.

AI assists. Specialists decide. State systems remain the official systems of record.
  • AI-assisted outreach with human review
  • AI-assisted translation and accessibility
  • AI-assisted case summarization for specialists
  • Workflow prioritization with human override
  • No autonomous eligibility decisions
  • No black-box decisioning

See the platform in action.

Request a private walkthrough for your agency or implementation team.

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