Claims and workflow fix for private medical groups

Stalled claims and authorizations, fixed one workflow at a time.

We measure a baseline, connect your existing tools, and give every open item an owner and a due date, with your staff reviewing the exceptions.

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Where work stalls

  • Claim sent back, next step unclear
  • Authorization waiting on a reply
  • Open item with no named owner
  • Follow-up with no due date
  • Payment waiting on an open item

How we work

One stalled workflow, fixed in the right order

We fix one stalled workflow for your clinic group, such as claims or authorizations that sit unresolved because nobody clearly owns the next step. The goal is for staff to spend less time chasing open items and for payments to move faster, measured against a baseline.

Clear ownership

Every open item has an owner, a next step, and a due date.

Less chasing

Approved reminders go to staff, so fewer items sit unresolved.

A clear baseline

We agree on what to measure before we change anything, such as open items, staff hours, and days to payment.

Where it stalls

Items sit unresolved when no one owns the next step

A claim comes back, or an authorization waits on a reply, and each person assumes someone else has it. Drag the strip, or pick an example to see how we look at it. These are illustrative examples, not client results.

Example: Claims

A claim is sent back and nobody owns the next step

A claim comes back for a missing detail, and it sits because no one is named to fix it. We give the item an owner, a next step, and a due date, and staff review any exception.

How it works

Four steps, measured against a baseline

  1. Measure the baseline

    We agree on what to measure before we change anything, such as open items, staff hours, and days to payment.

  2. Connect your existing tools

    We connect the tools you already use, so open items are visible in one place.

  3. Assign every open item an owner and due date

    Each open item gets a named owner, a next step, and a due date. Approved reminders go to staff.

  4. Staff review exceptions, and we report

    Your staff review every exception, and we report against the baseline. The goal is less time chasing open items and faster payments.

Why us

Why clinic groups work with us

Healthcare IT depth

Over 10 years of experience in healthcare IT, including clinic operations and compliance.

Process first

We fix the workflow before adding any automation, and every automated step has a human checkpoint.

Pilot approach

A pilot is one stalled workflow, measured against a baseline, with a clear scope and stop date.

Clear limits

What we do not do

  • We are not a billing service.
  • We do not do coding or appeals.
  • We do not message patients.
  • We do not access patient data without a signed business associate agreement.

FAQ

Questions clinic groups ask

What does a pilot include?

A pilot covers one stalled workflow in your clinic group. We measure a baseline, connect your existing tools, assign each open item an owner and a due date, and automate approved reminders for staff, with a human checkpoint on every exception. Then we report against the baseline.

How is it priced?

A fixed fee, agreed in writing before any work starts. We begin with a short paid review of one workflow to set the baseline and the scope. There is no monthly commitment up front. Ongoing support is optional and only discussed after the pilot.

Do you access patient data?

Not without a signed business associate agreement.

Do you replace staff?

No. The goal is for your staff to spend less time chasing open items.

Do you use AI?

Only for a step that truly needs it.

Book a 20 minute call

Tell us which workflow slows your team down

In 20 minutes we can talk through one stalled workflow and whether a pilot fits your clinic group.

Please do not enter patient information in this form.