Track claims from submission to payment — denials, payments, payers, and fee schedules with a full audit trail.

Table · Staff

Your billing team roster: each specialist and manager linked to their login, so claims, clients, activities and documents can be assigned to a named person and worklists stay personal.

• 5 fields · 4 recs
• 1 text
• 2 select
• 1 email
• 1 connection

Table · Clients

The provider practices you bill for, each with an assigned specialist and a portal login so they can check their own claims instead of calling you.

• 9 fields · 2 recs
• 4 text
• 2 select
• 1 email
• 2 connection

Table · Payers

The insurers you bill, including each payer's timely-filing and appeal windows that drive every deadline in the system.

• 6 fields · 4 recs
• 2 text
• 1 select
• 3 number

Table · Denial Codes

Lookup of the CARC denial reason codes a payer can return, grouped by category, so every logged denial is classified consistently and the worklist can be sorted by cause.

• 3 fields · 20 recs
• 2 text
• 1 select

Table · Fee Schedules

Each client's contracted rate per procedure code, used to auto-fill charges on claim lines so amounts are right the first time and underpayments stand out against the expected fee.

• 5 fields · 10 recs
• 2 text
• 1 currency
• 1 decision_box
• 1 connection

Table · Claims

The heart of the app: every claim you bill, with its payer, assigned specialist, status, balance and the timely-filing and appeal deadlines that decide whether the money is still recoverable.

• 23 fields · 30 recs
• 3 text
• 6 date
• 1 currency
• 2 decision_box
• 2 select
• 1 number
• 3 connection
• 3 rollup
• 2 dynamic

Table · Procedures

The billed procedures on each claim, with charges auto-filled from the client's fee schedule so claim amounts are right the first time.

• 10 fields · 55 recs
• 3 text
• 1 number
• 1 currency
• 1 select
• 4 connection

Table · Submissions

Each attempt to send a claim to a payer, so you can see when it went out, whether it was accepted or rejected, and what needs resubmitting.

• 8 fields · 35 recs
• 2 select
• 1 date
• 1 text
• 1 long_text
• 3 connection

Table · Denials

The denials worklist: every denied claim with its CARC code, category, appeal status and appeal deadline, so specialists always know what to work next.

• 12 fields · 11 recs
• 2 date
• 1 text
• 2 select
• 1 long_text
• 1 files
• 5 connection

Table · Payments

Payments and adjustments posted against claims, so balances resolve and managers can watch collections in real time.

• 8 fields · 15 recs
• 1 date
• 1 currency
• 1 select
• 1 text
• 1 files
• 3 connection

Table · Activities

The follow-up log: every call, note and payer contact a specialist makes on a claim or client, with the next follow-up date that keeps the claim from going quiet.

• 9 fields · 13 recs
• 2 date
• 1 select
• 1 text
• 1 long_text
• 4 connection

Table · Documents

Medical records, authorizations, EOBs and appeal letters attached to a claim or client, uploaded by staff or by the provider through the portal to unblock a submission or appeal.

• 6 fields · 8 recs
• 1 select
• 1 files
• 4 connection

Table · Audit Log

Append-only record of who created or changed a claim and when, written automatically by the app for compliance review and never edited by hand.

• 5 fields · 57 recs
• 1 date_time
• 1 select
• 1 text
• 1 long_text
• 1 connection

Table · Inquiries

New-client inquiries submitted through your public website form, held with contact details and a status so managers can follow up with prospective practices.

• 7 fields · 3 recs
• 3 text
• 1 email
• 2 select
• 1 long_text

Role · Admin

Sets up payers, denial codes, fee schedules, staff and clients, reviews the audit trail, and is the only role that can delete.

• 1 user

Role · Billing Manager

Sees claims and collections across the whole book, reassigns work between specialists, and receives deadline escalations and the weekly A/R digest.

• 1 user

Role · Billing Specialist

Works their assigned clients' claims day to day: creates and submits claims, follows up, appeals denials and posts payments.

• 2 users

Role · Provider Client

A practice's back-office user who logs in to see only their own claims, payments and A/R, and uploads documents you are waiting on.

• 2 users

Role · Public

Visitors who submit the new-client inquiry form on your website, with no login and no access to any data.

Workflow · Claim create

Numbers each new claim, assigns it to the client's specialist and calculates the timely-filing deadline from the payer's rules so the clock is visible from day one.

• 4 steps
• on Claims

Workflow · Claim payer or date-of-service change

When a claim's payer or date of service changes, recalculates the timely-filing deadline from the new payer's rules so the filing clock stays accurate.

• 2 steps
• on Claims

Workflow · Procedure create

When a procedure line is added to a claim, inherits the claim's client and specialist and fills in the charge from the client's fee schedule automatically.

• 2 steps
• on Procedures

Workflow · Submission create

When a claim is sent to a payer, marks the claim as in flight and stamps the first submission date so timely-filing status is tracked from the moment it goes out.

• 2 steps
• on Submissions

Workflow · Rejection handling

When a submission comes back rejected, flags the claim and emails the specialist with the filing deadline so it gets corrected and resent in time.

• 1 step
• on Submissions

Workflow · Denial intake

When a denial is logged, calculates the appeal deadline from the payer's window, marks the claim denied and alerts the specialist so the appeal clock never runs silently.

• 7 steps
• on Denials

Workflow · Payment posting

Applies each posted payment to its claim, updates the balance and closes claims out as they are paid in full.

• 2 steps
• on Payments

Workflow · Activity logged

When a specialist logs a call or note, stamps the author, records the claim as touched and moves its next follow-up date forward so the worklist reflects the latest action.

• 3 steps
• on Activities

Workflow · Document upload

When a provider uploads a record or authorization through the portal, links it to the claim and tells the specialist it may unblock a submission or appeal.

• 2 steps
• on Documents

Workflow · Claim reassignment propagation

When a claim is reassigned to a different specialist, re-keys all of its procedures, submissions, denials, payments, activities and documents so the new owner sees everything.

• 1 step
• on Claims

Workflow · Client reassignment propagation

When a client is moved to a new specialist, reassigns all of that client's open claims, which in turn cascades to every related record.

• 1 step
• on Clients

Workflow · Daily aging and follow-up refresh

Every day, re-ages every open claim into its A/R bucket and flags the claims whose follow-up date has arrived so the worklist is always current.

• 4 steps
• on Claims

Workflow · Appeal-deadline escalation

Every day, finds denials whose appeal window is about to close without an appeal filed and emails both the specialist and the managers, so a missed deadline takes two people to fail.

• 2 steps
• on Denials

Workflow · Filing-deadline warning

Every day, warns the specialist about claims that still have not been accepted as their timely-filing deadline approaches, before the revenue becomes unrecoverable.

• 2 steps
• on Claims

Workflow · Weekly aging digest

Every week, emails managers an A/R digest by aging bucket and payer, with the oldest balances and open denials, so they know where to push.

• 1 step
• on Claims

Workflow · Monthly client summary

Every month, sends each provider practice a summary of charges, payments, adjustments, A/R and denials with a link to their portal.

• 2 steps
• on Clients

Workflow · Audit - claim record events

Every time a claim is created or edited, appends a row to the Audit Log recording who made the change and when, giving managers a full history of every claim.

• 1 step
• on Claims

Workflow · Inquiry intake

Routes each new-client inquiry from your website form straight to the billing managers so prospective practices get a fast reply.

• 2 steps
• on Inquiries

Email · Claim Rejected

Rejected: {{claim_number}} ({{client_name}})

Email · Denial Logged

Denied: {{claim_number}} - {{denial_category}}

Email · Appeal Deadline Escalation

{{days_remaining}} days to appeal: {{claim_number}}

Email · Filing Deadline Warning

{{days_remaining}} days to file: {{claim_number}}

Email · Weekly Aging Digest

Weekly A/R digest

Email · Monthly Client Summary

{{client_name}}: {{month}} billing summary

Email · Portal Document Uploaded

{{client_name}} uploaded a {{doc_type}}

Email · New Client Inquiry

New inquiry: {{practice_name}}

AI agent · Denial Triage and Appeal Drafter

Reads a denial, works out whether it needs a corrected resubmission or a true appeal, and drafts the appeal letter for the specialist to review.

• 5 tools

AI agent · Claim Readiness Checker

Runs a pre-submission checklist on a claim and lists what is missing or inconsistent before it goes to the payer.

• 5 tools

AI agent · A/R Worklist Prioritizer

Picks the ten claims a specialist should work today, ranked by deadline risk and balance, and explains why each made the list.

• 5 tools

AI agent · Client Question Answerer

Answers a provider practice's questions about their own claims and payments in plain language, using only the records they are allowed to see.

• 3 tools

Page · Login

Page · Sign Up

Page · Profile

Page · Sample Page

Relationship

Clients connects to Staff through "Assigned Specialist".

• Clients
• Staff

Relationship

Fee Schedules connects to Clients through "Client".

• Fee Schedules
• Clients

Relationship

Claims connects to Clients through "Client".

• Claims
• Clients

Relationship

Claims connects to Staff through "Assigned Specialist".

• Claims
• Staff

Relationship

Claims connects to Payers through "Payer".

• Claims
• Payers

Relationship

Procedures connects to Clients through "Client".

• Procedures
• Clients

Relationship

Procedures connects to Staff through "Assigned Specialist".

• Procedures
• Staff

Relationship

Procedures connects to Claims through "Claim".

• Procedures
• Claims

Relationship

Procedures connects to Fee Schedules through "Fee Schedule Item".

• Procedures
• Fee Schedules

Relationship

Submissions connects to Clients through "Client".

• Submissions
• Clients

Relationship

Submissions connects to Staff through "Assigned Specialist".

• Submissions
• Staff

Relationship

Submissions connects to Claims through "Claim".

• Submissions
• Claims

Relationship

Denials connects to Clients through "Client".

• Denials
• Clients

Relationship

Denials connects to Staff through "Assigned Specialist".

• Denials
• Staff

Relationship

Denials connects to Claims through "Claim".

• Denials
• Claims

Relationship

Denials connects to Denial Codes through "Denial Code".

• Denials
• Denial Codes

Relationship

Denials connects to Denials through "Client Portal User".

• Denials
• Denials

Relationship

Payments connects to Clients through "Client".

• Payments
• Clients

Relationship

Payments connects to Staff through "Assigned Specialist".

• Payments
• Staff

Relationship

Payments connects to Claims through "Claim".

• Payments
• Claims

Relationship

Activities connects to Clients through "Client".

• Activities
• Clients

Relationship

Activities connects to Staff through "Assigned Specialist".

• Activities
• Staff

Relationship

Activities connects to Claims through "Claim".

• Activities
• Claims

Relationship

Documents connects to Clients through "Related Client".

• Documents
• Clients

Relationship

Documents connects to Staff through "Assigned Specialist".

• Documents
• Staff

Relationship

Documents connects to Claims through "Related Claim".

• Documents
• Claims