Billing checks that raise alerts and wait for a person
The billing agent watches eligibility, authorizations, payers, batches and denials, and turns what it finds into alerts. Your team decides what happens to each one, and the agent never submits a claim.
A held line, fixed before the batch goes out.
A line with an expired authorization is held. Once the new authorization is on file, the line is rechecked and goes out with the rest of the batch.
- Held lines explain why they are held
- Rechecked in one step once fixed
- Payments posted back to each line
A check at each step a claim takes
Each task watches one step on the way from service line to payment: eligibility and authorizations before billing, batches and claim files before submission, then status, remittances and denials after. When a task finds something, it records an alert and the billing team decides what to do.
- ✓Schedules are off until your agency turns them on
- ✓The agent prepares batches for review. It does not submit claims.
- ✓AI-drafted appeal letters are drafts until your team sends them
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Visit and note Session times and the approved note land on one service line.
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Pre-billing check
- Authorization and units left
- Signatures present
- No overlapping times
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Claim sent MN-ITS for MHCP, Availity for managed care. 837P
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Status tracked Accepted, pending or denied, by line. 276 / 277
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Payment posted The remittance posts back to the line it paid. 835
FlaggedA line that fails a check is flagged for your billing team with the reason attached, so it can be fixed before it comes back denied.
What the agent watches for
Each check ends in an alert a person can act on, while the problem is still easy to fix.
Eligibility requests
Checks coverage for clients with visits coming up, so a lapse shows before the visit instead of after the claim.
Authorization tracking
Flags authorizations that are ending or running low on units while there is still time to renew them.
Coverage gaps
Spots services that need an authorization the current payer does not have on file, often the first sign of a plan change.
Payer mismatches
Catches lines headed to a payer the client’s record does not support, before they go out.
Overlapping sessions
Finds one staff member documented with two clients at the same time.
Draft batches
Groups ready lines by payer for review. Your team still decides what is submitted.
Claim file pre-check
Checks each batch before it is sent, so errors are fixed before a payer sees them.
Denial review
Summarizes the likely cause of each new denial and drafts an appeal when one looks worthwhile, for your team to review.
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Sent Claim file submitted 837P
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Acknowledged The file was received and read 999
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Status by line Accepted, pending or denied 277
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Posted Payment or denial lands on the line 835
It follows the claim to payment
Once a batch is submitted, the agent's follow-up tasks watch it and raise an alert when a response needs someone.
- ✓Claim status: keeps checking submitted managed care claims through Availity
- ✓Remittances: posts 835 payments as they arrive and flags any that do not reconcile
- ✓Digests: email summaries of open alerts for people who are not in the dashboard
Every finding waits for a person
The billing agent dashboard shows what it found and what is still open. Each alert says what it is about and how urgent it is, and a person resolves or dismisses it.
- ✓Sort the queue by what is most urgent
- ✓A record of every check and what it found
- ✓Run a check whenever your team needs it
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A check runs AraSync
In the background, or whenever your team runs it.
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Findings become alerts AraSync
Each one says what it is about and how urgent it is.
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Someone decides Person
Resolve or dismiss it from the alert queue.
Every run is recorded
You can see what each check found.
If a check itself fails
It raises its own alert instead of failing quietly.
Checks that run in the background
Some billing checks run on their own, and what they find still goes to a person.
- ✓Pre-billing scan: possible overlaps, duplicates, authorization or unit gaps, and missing provider or diagnosis details, sent to the billing team
- ✓Roster eligibility: coverage checked for every client each month
- ✓Eligibility holds: lines for a member shown as ineligible wait until coverage is confirmed
- ✓Payer responses: acknowledgments and remittances from MN-ITS and Availity are picked up automatically
See the alert queue with your own payers
We will show what the agent flags for eligibility, authorizations and denials, and how your team works each alert.