Before the visit
Move eligibility and authorization surprises upstream.
Upcoming appointments can surface coverage that still needs verification and authorizations nearing expiration.
What if the claim never lost the context that created it?
Connect coverage, documentation, charges, payer rules, submission, denials, remittance, and patient responsibility to one visit record.
Eligibility → superbill → 60+ rules → clearinghouse → denial + appeal → ERA → patient balance
A visible claim lifecycle
Each stage has different owners, but the patient, visit, clinical, and payer context should not fragment at every handoff.
- 01
Verify
Eligibility and authorization attention before the visit
- 02
Document
Signed clinical context and reviewed code suggestions
- 03
Prepare
Visit-linked superbill, diagnoses, services, and charges
- 04
Scrub
More than 60 payer rules maintained in an admin editor
- 05
Submit
837P and clearinghouse response context
- 06
Resolve
Denial review, appeal work, aging, and follow-up
- 07
Post
835 remittance, adjustments, and patient responsibility
LIVE / 02
The claims workspace shows the queue and the rules.
The authorized demo tenant exposes claim stages, attention work, and a denial rules engine in one billing surface. Synthetic records protect patient privacy while preserving the workflow.
- Claim-state visibility
- Aging and attention work
- Denial-rule context
- Revenue reporting handoff
Before submission
Review the charge path while chart context is still available.
Diagnoses, services, patient, provider, and visit information flow into the superbill before the payer-rules pass.
After submission
Keep clearinghouse responses next to claim follow-up.
Submission, claim status, response, and 835 remittance context remain visible in the revenue workspace.
CONTROL / PAYER RULES
A rules engine billing leaders can maintain.
Charts includes more than 60 claim rules plus an administrative editor for payer-specific checks. The purpose is to surface preventable problems before submission—not to conceal logic in a vendor black box.
- Input
- Documentation, diagnoses, CPT, modifiers, eligibility, and payer context
- Action
- Flag a rule, route it for review, and preserve the correction trail
- Owner
- Authorized billing and administrative roles
Insurance and patient responsibility can share one ledger.
Card on file, payment plans, kiosk collection, receipts, and Text-to-Pay stay attached to the patient balance created after claim and remittance activity.
PI cases need more than a generic claim row.
Case type, lien and settlement status, imaging, narratives, optimization, documents, and attorney-facing records remain connected to the longitudinal clinical chart.
Billing and claims questions
Direct answers about fit, migration, ownership, AI review, and the connected platform.
01Can Charts handle insurance and self-pay workflows together?
Yes. The platform connects eligibility, superbills, electronic claims, remittance, denial work, card on file, payment plans, kiosk balances, and Text-to-Pay to the patient and visit context.
02Does Charts include claim-scrubbing rules?
Yes. The Charts billing surface includes more than 60 claim rules and an administrative payer-rules editor so billing leaders can maintain pre-submission checks.
03Can staff work denials and appeals in Charts?
Yes. The connected revenue workspace supports denial detection, claim attention, appeal work, and follow-up context alongside the clinical and submission record.
04How does eligibility connect to the appointment?
Upcoming visits can surface unverified coverage and expiring authorizations before arrival. The insurance context stays connected to the appointment, patient, charges, and claim.
05Does Charts support PI and lien workflows?
Yes. Personal-injury and auto-accident workflows include case, lien, settlement, documentation, optimization, and attorney-facing context connected to the clinical chart.
06Does billing automation guarantee claim payment?
No. Charts supports preparation, rules, submission visibility, denial work, and follow-up. Payer decisions, coverage, documentation, coding, and reimbursement remain subject to the applicable patient, provider, and payer context.
Bring one rejected or denied claim scenario.
We’ll trace where documentation, payer rules, submission response, appeal work, and patient responsibility stay connected.