Grow your practice without growing the back office.
We automate eligibility checks, prior authorizations, claims and the follow-up, in your EHR and in the payer portals your staff uses today. Cases that need a person go to your team.
How it works
- Starts when an appointment is booked.
- Checks coverage in the payer portal.
- Saves the result in PrognoCIS, the EHR.
- Sends the billing data to TriZetto.
- Inactive coverage and missing IDs go to staff.
What we automate for providers
Registration and intake
We check patient details and intake forms before the visit and enter them into your EHR. Missing or mismatched details go to your front desk.
Eligibility and benefits
Plan, effective and term dates, PCP, copay, deductible, coinsurance and coordination of benefits, checked in payer portals and saved to the patient record.
Prior authorization
We collect the order and clinical documents, fill in and submit the request, and check its status until the payer answers. The payer still makes the decision.
Claims and follow-up
We prepare and submit claims, check their status, and flag the ones that are stuck or denied.
Payment posting
We post remittances to the right patient, claim and service line, and flag duplicates and mismatches.
DME and HME companies: 46 automations in Brightree.
Home medical equipment companies handle orders, CMNs, resupply, deliveries and equipment returns, on top of billing.
We have 46 automations involving Brightree in production. They cover documents, orders, billing and the warehouse.
Where they run
- Orders and clinical work: 16
- Warehouse, shipping and assets: 13
- Documents and CMNs: 9
- Billing, claims and payments: 6
- Device platforms: 2
Proven in production
Eligibility ChecksEligibility checks for a 13-clinic pain management network
Read the case study
Pre-AuthsPrior authorization across payer portals
Read the case studyPre-auth automation project for a cancer treatment clinic
See it on our pricing pageShow us the work your staff does by hand.
Let Karl, our CTO, take a look. It’s 30 minutes with the person who designs the automations, not a sales script.
Walk me through the process your team does by hand. I’ll tell you whether it’s worth automating and how I’d approach it.
Karl