Problem Statement

Charges held by edits sit unbilled until staff manually resolve the flagged issue. When a charge is flagged for missing active coverage, it can't bill until the right plan is attached, so a biller has to check the patient's coverage list and add the applicable coverage before releasing it. While these accounts wait, they accumulate in Discharged Not Final Billed (DNFB), lengthening time-to-cash and risking revenue leakage on services that were performed but never cleanly billed.

Automation Solution

This automation reviews Epic charge review workqueue charges flagged for active coverage, adds applicable coverage from the patient's coverage list, and releases the charge.