Solutions / Claims Management
Claims Management
From clean claim to paid claim, with the status visible at every hop.
The gap between submitting a claim and knowing what happened to it is where most AR ages. Claims are scrubbed before they go, tracked after they go, and their status is retrieved rather than phoned for — so a claim stuck at the clearinghouse for nine days is something you find out about on day one.
How the AI works
- 01
Scrub before submit
Completeness, code conflicts, payer-specific formatting and eligibility checked while a fix is still cheap.
- 02
Submit and track
Every claim followed through clearinghouse acceptance and payer adjudication, with the hop it is sitting on visible.
- 03
Pull status automatically
Claim status retrieved on a schedule instead of a biller waiting on a payer phone queue.
Humans in the loop. By architecture.
Nothing is auto-corrected invisibly. When a claim is changed before submission, the change and the reason are on the record, because an unexplained edit is the thing that makes an audit painful two years later.
Questions, answered
What is claim scrubbing?+
Checking a claim against payer rules, code edits and completeness requirements before it is submitted, so predictable rejections are fixed upstream instead of appealed downstream.
How quickly do you know a claim was rejected?+
Clearinghouse-level rejections surface on the acknowledgement rather than being noticed when the payment does not arrive. That distinction is usually worth weeks of AR.
Do you work our existing aged AR?+
Yes. It is usually the fastest cash in the building, and the first pass is classification — a large part of most aged AR is not workable and should be recognised as such rather than reworked.
More of the engine:AI Medical Coding,AI Claim Review,AI Documentation,AI Workflow Automation,Staff Augmentation,Business Process Outsourcing,Automation Services,GetMax RCM Platform,AI Coding Assistant,Denial Analytics,Practice Dashboard,Revenue Intelligence,Patient Eligibility Platform,Reporting & Analytics
Book a Demo