The patient is the work. Everything else is the work around the patient.
Prior auths, denials, coding, the deductible the patient can't make sense of. Held in your head or scattered across six payer portals. I hold the paperwork so you can hold the care.
If you want to find out what I can do for you,
Why does every Aetna claim leave on a Thursday.
My first week, I read ninety days of your claims before I touched one. Every Aetna claim went out on a Thursday. Every Cigna referral went by fax, never through the portal. Nobody had written down why.
So I asked your biller.
Forty patients today. Fifteen eligibility checks. One denial with a clock on it.
Eligibility to verify before noon. A prior authorization that expires at five. A denied MRI on a patient you haven't pulled up since Friday. None of them need you this hour. All of them need you this week.
By Monday afternoon, two have slipped without you noticing.
Prior auths. Appeal windows. Timely filing. None missed.
A prior auth that expires at five. An appeal window closing in three days. A timely-filing limit nobody flagged. Each one costs the practice money if it slips.
One of them slips through. Always one.
A denied claim at 9pm. A patient who needs to understand the bill by morning.
An Explanation of Benefits lands. The scan was denied, six hundred dollars sits in the patient's name. They read English as a second language and they think it's a bill they have to pay tonight.
By the time you see the message, they're already worrying in the dark.
What you need to know before the carrier denies it.
Each carrier has its own dance. UnitedHealthcare wants the clinical notes up front. Aetna wants the imaging attached. Blue Cross Blue Shield wants a specific code or it bounces. Cigna wants a referral on file.
Held in your biller's head. Lost the week she's out.
A patient walks in with eight years of history. The team has six minutes to read it.
Your 11am has been with you four years. Several visits, two surgeries, one carrier that switched at open enrollment, one balance that's still in appeal. They expect the team to remember all of it.
Nobody on shift today saw the last visit.
Every patient is a thread. Held, not scattered.
The chart, the claims, the prior auths, the portal messages, the balance. They live in different systems and different heads. The patient scatters. The history scatters.
Trust scatters with it.
Every patient is a single thread. The visits, the coverage, the claims and appeals, the coding, the balance, the patient's questions in their own language. You read the thread, not the portal.
UnitedHealthcare PPO, in-network.
Eligibility verified, deductible met.
Active through year end.
MRI lumbar, billed $1,420.
Denied CO-197, patient shown $612.
Appeal window 180 days, 3 left to file clean.
Peer-to-peer held for 11:30.
Clinical notes pulled & attached.
Patient asked in Spanish why they owe.
Want to watch Cait run a real day?
Two minutes, narrated. A prior auth chased, a denial fought, a patient answered in their own language.
Take the guided tour ↗Try me.
The crazier your schedule, the messier your inbox, the thornier your follow-ups, the better. Bring me what you'd hide from a new hire. Then ask me about it in three months.