Features.
Every part of the revenue cycle.
Over 25 years of billing and EHR experience in one modern platform, with denial management at its core and AI built in. Here is what each part does.
Our focus
Denial management
A denial is a case with a queue, a deadline and a next step, from the day the remittance is posted until the claim is paid, appealed, corrected or closed.
- Cases are created from posted remittances, grouped by claim and payer; nobody keys them in
- Each case goes to a work queue you set up, routed by payer or insurance class
- Lists show My work, Untaken, Deadline soon and High dollar, and group cases by next step
- Estimated appeal-by and corrected-claim-by dates count down on every case
- Every denial code carries a category and a recommended action: correct and rebill, appeal, send records or review
- Priority weighs the balance, the deadline and how often that payer later paid that denial code
- Rebilling marks the case and sets a follow-up date; a paid case closes on its own; a claim denied again comes back
- Claims rejected by the clearinghouse or the payer before adjudication become cases too
- Pre-bill rules hold or flag a charge a payer has denied before, while claims are being built
- Jacqueline, the AI agent, can look up a case and draft the appeal letter
- Workload shows open cases by queue and person, and two reports show which payers deny most and how the cases ended
AI built in
Ask Jacqueline
Jacqueline is the AI agent that is part of the application, there to help across the practice. Ask in plain language and put the answer to work.
- Ask about your practice: totals for charges, payments and adjustments, by payer and date range
- Work denial cases: list your queue, open a case, add a note, set a follow-up or change its status, once you say yes
- Write appeal letters, collection letters, letters of medical necessity, memos and summaries as Word documents
- Turn any list it has looked up into an Excel workbook
- Find the right report or billing screen and get a link that opens it
- Get step-by-step help for any task, and explanations of codes and denial reasons
- Read a public payer policy page you paste and answer questions about it
- Answers draw on a knowledge base of how-to guides, workflow notes and letter templates
- When an answer is wrong, a user can say so, and the correction is kept for review
- Private by default: patient-identifying information is kept out of AI requests unless your practice chooses to allow it
Patient accounts
Everything about a patient and their family account is one click apart.
- Register patients and keep their identity, contacts, guarantor and billing settings up to date
- Import from Document: upload the demographic sheets you received (PDF, JPG or PNG), and AI reads them and fills in the patient, new or saved; you check the fields and what was replaced before you save
- Record primary, secondary and tertiary coverage, with the subscriber, the insurance card and eligibility
- Track conditions: onset dates, diagnoses, authorizations and accident details
- See every charge, payment, adjustment, billing and note on the ledger, and act on them there
- View insurance and patient balances by age for the whole family account
- Keep scanned and uploaded documents, alerts and notes with the patient
Clinical
EMR
The visit note lives on the same patient account as the bill, so what the provider documents is what gets coded and billed.
- Write the visit note the way each provider likes, with common wording a click away
- Dictate straight into the note
- Add pictures and drawings to the encounter
- Chart teeth for dental visits and turn the treatment into charges
- Suggest Codes reads the note, suggests the procedure and diagnosis codes, and checks them against CCI edits, Medicare guidelines and your own billing rules before anything is billed
- Place orders, and a follow-up order becomes a recall with the right date
- Sign notes; unsigned notes and open orders wait in each provider's My Work list
- Signed visits go straight to the billing office, ready to bill
Scheduling
The appointment book is part of the application, so the front desk works on the same patient account as the billing office.
- Daily, weekly and monthly views: your providers side by side for the day, or one provider's week or month
- Pick an overview to choose which providers are shown, filter by location, and colour the calendar by appointment or by provider
- Book an appointment with its type, duration, location, department, condition, responsible coverage and up to three planned procedures
- See the patient's balances, last date of service and other appointments while you book
- Block time once, or on the days of the week it repeats; a blocked time either allows appointments over it or refuses them
- You are asked before an appointment is booked over another one
- Confirm an appointment, check the patient in to a room, and mark it seen, departed or no-show
- Find a patient's appointments, then reschedule, copy, cut and paste them on the calendar
- Schedule one appointment for a group of patients and keep its list of members
- Recalls: enter the reason a patient should come back and the date it is due, then schedule the appointment from the recall
- Open the patient's account or ledger straight from the appointment
- Cancel an appointment and keep it in the patient's appointment history
- Print the schedule
Charges and payments
Posting is done in batches you can check before anything reaches the ledger.
- Enter a batch of charges for one or more patients, check them and post them
- Electronic superbill: providers tick the visit on a sheet set up for them, in the web browser, and Send turns each procedure into a charge in the Charge Queue with its fee, coverage and diagnoses filled in
- Superbill from Scan: upload scanned paper superbills as PDF files, and AI reads the procedure and diagnosis codes the provider circled or checked by hand, and the visit date written on the page
- Check what was read against the scan shown beside it, pick the patient, and remove a code or add one that was missed; the charges reach the Charge Queue only when a person clicks Send
- Post patient and guarantor payments and apply them across the family's charges
- Post insurance payments across patients, with allowed amounts, adjustments, reason codes and the next responsible party
- EOB from Scan: upload a scanned paper EOB, and AI reads the payer, the check and what was paid and adjusted on each charge; you check it beside the document, and the insurance payment is created for you to post
- Apply unapplied patient and insurance credits to charges
- Reopen, post or discard batches from the charge and payment queues
- Close an accounting period: review its totals, export a general ledger journal and lock the transactions
Underpayments
Every insurance line is checked against what the payer should have allowed, as the payment is posted. Posting is never stopped or slowed by the check.
- The expected amount comes from your stored rate for the code, the plan's contract as a percent of Medicare or of your fee, or your usual fee
- Medicare's amount uses the Medicare locality of the charge's location, office or facility
- Each short line is listed with what the payer should have allowed, how much is missing and when the appeal is due, nearest deadline first
- Appeal it, record that the payer paid the difference, or accept it
- Print an appeal letter for a payer's short lines
- Entered a contract later? Check Past Payments checks the payments posted earlier
- The Underpayment Trend report shows, for each payer and month, how much was short and how much was recovered
Claims and EDI
Every claim is checked before it goes out, and remittances come back without retyping.
- Before a claim goes out, its charges are checked against CCI edits, Medicare guidelines and your own billing rules
- An exceptions list shows the claims that need attention before the file is sent
- Select the charges that are ready for insurance, check them, and create electronic claim files or printed insurance forms
- Send claim and statement files, and receive remittances and reports from payers and clearinghouses
- Read an electronic remittance, check it against your charges, and send its payments to insurance payment posting
- Read the claim acknowledgements clearinghouses and payers send back: a rejected claim becomes a denial case, and a 277 report shows the acknowledgement in a form you can read
- Work with the files in each folder from one EDI Manager screen: find them by date and choose which columns the list shows
- Open a file line by line with a description of what each element holds, and edit an element when a file needs a correction
- Check eligibility electronically, keep the payer's answer with each coverage, and print an eligibility verification worksheet
Statements
Patient billing is as controlled as insurance billing.
- Choose which families or patients get a statement and review the list before it goes out
- Print paper statements or send e-statements
- Print a walk-out statement while the patient is still at the desk
- Set up payment plans so a patient can pay a balance in regular installments
- Print receipts for patient payments
Reports
The numbers are grouped the way a practice is run: by provider, location, department, billing entity, insurance plan and operator.
- Day sheets, monthly journals and yearly journals
- Aged receivables by patient or by responsible party
- Charge and payment analysis by procedure, diagnosis, payer, financial class and more
- Reason code analysis and denial reports
- Billing detail and summaries, pending insurance and coverage reports
- On the preview, switch between a report's main report and its summaries without building the report again
- Custom reports of your own, and a history of the reports already run
Built in
Chat and text messages
Talk to the rest of the practice without leaving the account you are working on, and reach patients by text.
- Chat with one person or a group; messages arrive as they are sent, on whatever screen people are working
- Start a group from a role, such as all billers, and everyone with that role at every site of the practice joins
- Link a patient to a message, so the person you are chatting with opens the account in one click
- Your chats are always listed, with a mark and a count on any that have new messages
- Keep the chat floating, dock it beside the page, or open it in its own tab to put on a second monitor
- Send a one-way text message to a patient who has agreed to texts; every text names the practice and gives its number to call
- Text a coworker's mobile phone, and get a text when a chat message has waited unread
- Each text is kept with the patient's record, and only staff given the privilege can send them
Administration
Built for organizations with more than one site and more than one kind of user.
- Sign-in is protected with multi-factor authentication
- Give people access, choose their role, and set which parts of the application they can use on each site
- Connect from anywhere, on any platform: the application runs in your web browser
- Run several sites under one organization and switch between them
- Set up fee schedules, insurance plans, providers, locations, procedures and the rest of your billing tables
- Print from anywhere to anywhere: wherever you are signed in, print to any office printer connected through the Print Service
- Help on every screen with F1, and a searchable Help Center
Coming next
In development. Not part of the product today.
- HL7 interface: exchange patient and charge information with other systems in the standard HL7 format
Want to see it working?
We will walk you through the parts that matter most to your office.
Request a Demo