Healthcare: the doubts, not the drudgery.
Revenue-cycle work: remittances, denials, prior authorisations and coding audits. Many of these judgements can be checked against the payer's own data; the rest reach a person with the record.
Where the time goes
Remittances that don't match what was billed
Denials worked one by one
Prior authorisations held up by missing information
Standard workflows for healthcare
7 workflows · Cross-checked: 4 · Proven by code: 2 · Checked by the outcome: 1
Remittance posting and payer reconciliation (835s)
Which claims a remittance pays; adjustments
Claim denial management and appeals
Denial reason, appealable, evidence
Prior authorisation
Criteria met from the record
Medical coding audit
Codes supported by the notes
Eligibility and benefits verification
Coverage active, benefits apply
Provider credentialing
Licences, sanctions, documents current
Charge capture reconciliation
Services delivered vs billed
What buyers ask
Which process should we start with?
The one with the most items your team checks by hand and a clear way to tell right from wrong: usually a reconciliation or a matching process. Its judgements are proven by code, so most settle without a person.
Do you connect to our systems?
Files in any layout (spreadsheets, CSV, PDF, bank formats), e-mail inboxes and folders, and an API for software. Connectors for particular systems are built as customers need them.
How long does a pilot take?
A few weeks alongside your own process, on your own data, at our cost. It ends in a line-by-line comparison: what it settled, what it sent to people, what it caught, and the time it took.
Bring one healthcare process. Run it alongside yours.
We design it with your expert, run it in parallel, and show you the comparison.