Problem Statement

Coverage and benefit details must be confirmed and entered accurately before billing, and doing this manually at volume is slow and error-prone. Accounts often carry a self-pay balance when billable insurance actually exists but was never linked, so the balance sits with the patient while a payer that would have paid goes unbilled. Gaps like these surface later as avoidable rework and lost revenue.

Automation Solution

This automation identifies accounts with self-pay balances where there is unlinked but available insurance, adds the new payer information, and resubmits the claims.