Healthcare providers
Claims that go out clean the first time
Referrals, claims and prior authorizations moved between your EHR and each insurer.
Orthopedic clinic
835 remits posted 07:15
Referrals waiting on auth
14
6 past the payer’s decision window
See what holds up each claim
Coding errors, insurer rules and missing authorizations caught before submission, so less revenue is written off.
- Denials grouped by causeOne fix to the rule behind them clears the whole batch.
- Appeals before the deadlineAppeal letters drafted from the denial reason and chart note, dated to the filing limit.
- Underpayments caughtEach insurer payment compared with the contracted rate, line by line.
Orthopedics · commercial PPO · date of service Jul 9Held by edits
Billed
$1,284.00
Place of service
11 · office
Edits open
2
Submission
X12 837P
Clean-claim rate, 30 days
Held for a person
2Corrected automatically
6Ready to submit
31Carry a referral from the fax line to a booked visit
Pages are sorted and matched to the patient, and staff handle only what needs a person.
- Lost referralsPatients sent to you who never booked, by the office that sent them and why.
- Authorized visits countedEach booking is subtracted from the number the insurer approved.
- Need-to-know accessEach person sees only what their role, location and care team require.
Fax received Jul 9 · orthopedics5 steps
Referral, orders and insurance card · Jul 9 · automaticDone
MRN match against the practice record · Jul 9 · automaticDone
Payer reply in · owner: registration · day 2In progress
A plan mismatch routes to registration with the payer response attachedOpen
Payer portal · owner: auth coordinatorWaiting
Slot offered to the patient · target Jul 16Waiting
The referring office hears back at each step.
Billing work that waits on insurers
From the first referral to the final payment.
- Registration · EHR
- Claim · billing
- Remittance · Waystar
- Registration · billing
- Claim · Waystar
- Remittance · A/R posting
Each claim batch is matched to the payer’s acknowledgments.
Connected to your EHR and clearinghouse
Patient and claim data move over HL7 and X12.
Patient data stays in your systems
Runs in your own network or private cloud under a business associate agreement, and logs every access.
Name the denial your team fixes every week
We plan the first build around that denial, at a fixed price.