MEDICAL BILLERS & REVENUE CYCLE TEAMS
Move the claim conversation forward.
Give your billing team a calling assistant for the questions that still require a representative. Work through claim-status calls, capture the details, and bring a biller in when the conversation needs judgment.
See this workflowWhat to have ready
- Patient and member information needed by the payer
- Claim number and date of service
- Billing provider details and the specific question
- Known submission history and relevant reference numbers
THE WORK BEHIND THE CALL
A claim aging report should lead to action.
A useful follow-up call establishes whether a claim was received, where it stands, and why it is stalled. It also distinguishes a processing question from an issue that needs a corrected claim, additional documentation, or a staff-reviewed appeal. The record should make the next action clear without asking someone to reconstruct the call.
Start with the right department.
Find published phone, fax and email routes, with source dates and plan-specific details.
Find claims contactsQuestions worth
getting answered.
- 01
Has the claim been received and what is its current status?
- 02
If it is pending, what is preventing the next step?
- 03
What payment or adjustment information can you confirm?
- 04
If an action is needed, what route and documents does the plan require?
- 05
What reference number and callback route should we use for follow-up?
What your team
gets back.
- Claim status as reported on the call
- Payment, adjustment, or missing-information details
- Reference number and representative name
- Open issues, staff-owned actions, and stated follow-up dates
A representative’s statement is recorded as a reported answer. It is not treated as proof of payment or a final claims decision. Staff review remittance and payer evidence through their existing process.
A few more details.
Claims follow-upCan the billing team work a list of claims?
Yes. Worklists apply a task template to multiple rows while preserving a separate outcome for each call. The office controls simultaneous calling capacity.
Does the assistant automatically appeal a denied claim?
No. It can ask about the denial and the follow-up route, record details, and flag the issue. Appeals and other consequential actions require the appropriate staff review and approval.
Will the answers appear in our billing system?
The current workflow provides an outcome record and worklist CSV export. Automatic write-back to a billing system or EHR is not currently included.
The next thing on your list.
For billing teams
Give medical billing teams an AI assistant for payer calls, claim follow-up, and worklists. Review exceptions and keep an auditable call record.
Insurance verification
Delegate payer calls for eligibility and benefits. Gather coverage details, referral requirements, and call references for your medical office to review.
LET’S TAKE ONE THING OFF YOUR LIST
Meet your office’s
new calling assistant.
See a workflow. Ask your questions.
Find out where an extra hand would help.