Artificial intelligence for your medical billing team

Real time eligibility via EDI, plus verification via payor portal

Coverage detection: avoid coordination of benefits issues

Patient estimates: estimate patient costs prior to the visit

Enrollment check: avoid out of network denials due to enrollment

Prior Auth check: know which procedures require prior auth.

Automated claims monitoring for no-response claims

Validation of EOBs/ERA vs. Payor Portals, vs Practice Management system

Validation of claim & denials vs external sources including find-a doctor portals, contract rates, correspondences, CLIA licenses & more.  

See contract rates in line with allowed amounts & claim payment data

Review prior auths every day to make sure all applicable visits have a valid prior authorization on file

Automatically apply for prior authorization via payor portal or by fax

Automatically compares medical record documents to prior authorizations, to ensure services rendered are medically necessary and in line with the prior auth, including effective dates, dosage, diagnosis codes and more

Continuously monitor outgoing claims that are pended for medical records, and automatically submit the correct medical record + prior authorization instantly

Showing each individual biller their queues, with smart sorting so they focus on the most urgent first

Prefilling common payor portals like Availity & United so billers don't have to copy/paste

Enabling faster eligibility and claim status checks than is possible manually