Industries · Physician Practices

The visit happened. The claim should not be optional.

A practice loses revenue in three places: the encounter that never became a charge, the claim denied for something knowable in advance, and the prior authorization that stalled until the patient stopped calling. All three are the same problem seen from different sides, which is why they belong on one spine.

The problem

Denial rates get reported. Missed charges never do.

A denial at least leaves a trace you can count. A charge that was never captured leaves nothing at all, which is why practices manage the number they can see and quietly bleed on the one they cannot. The gap between work delivered and work billed does not appear in any report your billing system produces, because that system only knows about claims that were created.

What you get

Four things change on the first day.

Encounters become claims automatically

The clinical event is the trigger, not a coder’s memory at month end. What was delivered is what gets billed.

Documentation checked while it is cheap to fix

A missing signature or consent is a thirty-second correction on the day of service and a six-week denial afterwards. The check runs on the day of service.

Prior auth that chases itself

The rejection opens the request, the clinical record attaches itself, and every open authorization stays visible and ageing until it resolves or escalates.

Payer behaviour, measured

How each payer actually pays you, by service and over time. The evidence you bring to a contract conversation rather than the impression you carry into it.

What is live today

No roadmap language. Here is the state of it.

The billing engine, the 837P/835 lifecycle and the authorization pipeline are production code, exercised by the same clearinghouse path pharmacy claims use. Connecting a practice management system is an adapter, the domain model already holds encounters, facilities and payers without change.

Every product listed below is complete and running: schema, API, permissions, entitlements, tests and documentation. What varies between organization types is the adapter that feeds them, and we will always tell you which one you need before you sign anything.

Start with one facility.

A read-only connection and credentials you can revoke. We come back with what the last month actually cost you, using your own numbers.