How It Works
From onboarding to
optimized revenue.
Our end-to-end process connects your ePCR, automates coding and submission, manages denials and collections, and surfaces insights — so you can focus on patient care while we optimize every dollar.
24–48hr
Claim turnaround
98.5%
First-pass acceptance
2–4wk
Onboarding timeline
6 steps
End-to-end process
Full visibility at every step — nothing hidden.
The Claim Lifecycle
See it in action.
Every claim moves through a transparent pipeline. Here's what it looks like inside the platform.
Claim Lifecycle Tracker
Intake
Mar 8, 2:14 PM
ePCR imported
Coding
Mar 8, 2:15 PM
AI auto-coded
Validation
Mar 8, 2:15 PM
12 rules passed
Submission
Mar 8, 2:16 PM
EDI transmitted
Acknowledgment
Awaiting 999/277
Payment
Pending
4 / 6
Steps Completed
12
Validations Run
Yes
Clean Claim
The Process
Six steps. Complete transparency.
Discovery & Onboarding
2–4 weeksWe learn your agency inside out — payer contracts, call volume patterns, existing workflows. Then we connect to your ePCR, import historical data, and configure your platform account. Your team gets hands-on training before a single claim is touched.
- ePCR integration setup
- Payer contract mapping
- Historical data import & benchmarking
- Team training & go-live support
Claim Creation & Coding
Incidents flow in automatically from your ePCR. Our AI reviews documentation, suggests HCPCS and ICD-10 codes, and flags gaps. Human coders verify every claim — the AI assists, but experienced billers make the final call.
- Automatic NEMSIS data ingestion
- AI auto-coding with confidence scoring
- Documentation gap alerts sent to crews
- Human review & QA on every claim
Submission & Real-Time Tracking
Clean claims are submitted electronically within 24–48 hours. Every claim is tracked through its full lifecycle in real time — you see exactly where it is and what's happening at every stage.
- Electronic submission within 24–48 hours
- Real-time status tracking across all stages
- Primary & secondary payer billing
- Compliance validation before submission
Denial Management & Appeals
Denied claims don't sit in a queue. They're automatically categorized, analyzed for root cause, and routed for correction. Multi-level appeals with full versioning ensure nothing falls through the cracks.
- Automated denial categorization & routing
- Multi-level appeals with documentation
- Predictive denial scoring to prevent rejections
- Root cause tracking to fix systemic issues
Payment Posting & Reconciliation
ERAs are auto-posted, deposits reconciled against bank statements, and patient balances updated automatically. Every dollar is accounted for — no manual spreadsheet reconciliation.
- ERA auto-posting & matching
- Bank deposit reconciliation
- Patient billing & white-labeled statements
- Payment plan management
Reporting & Continuous Optimization
Executive dashboards surface trends, opportunities, and risks in real time. Your account manager reviews data monthly and proactively recommends adjustments — we don't wait for problems to find us.
- Real-time KPI dashboards
- Performance Scorecard across 9 dimensions
- Payer mix & denial trend analysis
- Proactive recommendations from your account team
Timeline
What to expect
Most agencies are fully operational within a month. Here's the high-level timeline.
Weeks 1–2
Onboarding
Connect systems, configure platform, import data, train your team.
Weeks 3–4
Go Live
Claims flowing, real-time dashboards active, your team has full access.
Ongoing
Optimization
Continuous improvement, proactive recommendations, monthly performance reviews.
Ready to get started?
Schedule a call to discuss your onboarding timeline and see the platform in action.