Every submitted claim is tracked automatically: status checked, missing documents flagged, denials turned into corrected resubmissions within days — and an always-current aging report shows exactly where the money is.
Typical results
31 days
average time to payment, down from 52
100%
of claim statuses checked on schedule
Live
aging report shows exactly where the money is
Figures reflect typical results for this kind of automation.
The challenge
The billing clerk juggled hundreds of open claims in spreadsheets. Statuses were checked only when someone remembered, denials sat unnoticed past resubmission windows, and a meaningful share of earned revenue was simply written off.
Before and after
Average days to payment
−40%Denied or expired claims per month
−60%Hours tracking claims per week
−83%The automation
We automated the follow-up cycle: claim statuses are polled on schedule, payments are posted and matched automatically, and every denial opens a task with the denial reason, the patient file and a prefilled correction checklist. Claims approaching their deadline escalate to the clinic manager before it's too late.
How it works
- 01
Claim submitted
Every submitted claim enters the automated follow-up cycle.
- 02
Status polled on schedule
Claim statuses are checked automatically — no one has to remember.
- 03
Payments matched
Incoming payments are posted and matched to their claims.
- 04
Denials become tasks
Every denial opens a task with the reason, the patient file and a prefilled correction checklist.
- 05
Resubmitted within days
Corrected claims go back out inside the resubmission window, and the aging report stays current.
Starts from
- Submitted claims
- Payer responses
Delivers
- Denial tasks
- Payments posted
- Aging report
The impact
Denied and expired claims dropped by about sixty percent, average time-to-payment fell from fifty-two to thirty-one days, and the clinic recovered revenue that used to disappear quietly into the write-off column.
Questions about this automation
How are claim statuses checked?
A scheduled job queries each open claim's status through the payer portal, a clearinghouse or the billing system's API, usually once a day. Every status change is written back to the claim record, so the billing team works from current information instead of logging into portals one claim at a time.
What does a denial task include?
Each denial opens a task with the denial reason code, the patient file, the original claim and a prefilled correction checklist for that reason, such as a missing authorization number or a wrong procedure code. The task carries the resubmission deadline, and claims nearing it escalate to the clinic manager.
How are payments matched to claims?
Remittance files from payers are read automatically, and each payment line is matched to its claim by claim number, patient and amount. Exact matches are posted, while partial or unmatched payments are flagged for review. The aging report updates from the same data. This is a multi-step build, usually rolled out in stages.