You set the rules. We run the desk.
Every case moves from referral to a clean claim with one owner on our side. Routine steps get done and logged. Anything clinical, or outside your rules, comes to the person you name.
Follow a case from start to finish.
Pick a specialty and step through it. Each stage shows what comes in, what gets done, what waits for your approval, where problems go, and what your team sees.
Stages above the dashed line are what a first engagement would typically cover. Stages below it show how the work extends into billing once the first workflow has proven itself. Nothing here makes clinical decisions, determines medical necessity, or guarantees a payer's decision.
What stays with you, and what we take on.
Handing over work shouldn't mean losing sight of it. You decide the scope and the approval rules. We work inside them and record everything we do.
| The work | Your practice | Us |
|---|---|---|
| Clinical decisions, treatment choice, medical necessity | Always yours | Gather the documentation from the chart for your review |
| Scope and approval rules | You set and change them | Follow them and log every action |
| Benefits checks, submissions, status follow-up | Look in whenever you like | Do the work on a set schedule |
| Renewals | Set the lead time | Track every expiry and open renewals early |
| Exceptions | Decide when a decision is needed | Named owner, full context, tracked until resolved |
| Coding and claim content | Your coders or billing company, at first | Check the authorization matches before handoff |
| System access | You grant it and can revoke it | Use only what's agreed; every action attributable |
If you own the practice
Grow treatment and procedure volume without adding a coordinator for every new physician. Work with one accountable party instead of managing the gaps between vendors.
If you run the office or revenue cycle
You set the rules, approve the exceptions and see every case without chasing anyone. Fewer open roles to fill and fewer vendors to supervise, so your team's experience goes where it's needed.
An approval only counts once it reaches the claim.
Authorization tools usually stop at the approval. Billing companies usually start at the charge. Denials for "no authorization on file" happen in between, when the number, dates or units never made it across.
The same case record carries the referral, benefits and authorization into billing. Before the claim goes out, we check they match. If a denial still comes back, it's traced to the case it came from.
You keep your billing company. We hand them clean details through a format you agree on.
- Authorization numberMatches the chargeMatch
- Dates of serviceInside the approved windowMatch
- Drug, units and eyeAs approvedMatch
- Released to billingWith the clearance file attachedHanded off
How we'd be measured.
Many vendors report how much work their software touched. We'd rather be judged on how much of your staff's time a correctly completed case still needs, including approvals, exceptions, rework and time spent checking on us.
Before anything starts, we measure your current baseline together and report against it every week. We'll only describe results once we've measured them with you.
- Work moved to someone else doesn't count as saved.
- Errors and late cases count against us.
- Our fee is compared with what each case costs you today.
How an engagement runs.
No practice-wide migration. One defined piece of work, proven against criteria you agree to, then a decision together about what comes next. Setup and configuration are our job.
Understand the workflow
Volumes, people, vendors, tools, and where cases stall today.
About an hour of your timeAgree scope and access
Case types, payers, approval rules, access, and the baseline we'll be measured against.
Includes your security reviewRun alongside your team
We work real cases in parallel with your staff before anything goes out unchecked.
Your team spot-checksTake over agreed cases
We own the in-scope case types. Everything else carries on as today.
You approve exceptionsReport every week
Staff time per case, accuracy, timeliness, exceptions, rework, and what's still manual.
A short review togetherExpand, or stop cleanly
Add new authorizations or the billing handoff only if results justify it. If not, every open case comes back with its history.
Your decision