Back-office employee

An employee that works every denial and rebills what's recoverable

It reads the denial on each remittance, maps the denial code to the fix, corrects and resubmits the recoverable claims, and assembles the appeal packet for the rest - so denied revenue gets worked, not written off.

Watch it work
Northwind Medical
Threads
Huddles
Drafts
Channels
#general
#billing
#appeals
#random
Direct messages
AvaAPP
Priya Nair
# billing10 members
BIS|A</>
Message #billing
+@
>

The actual employee, working in your Slack.

Why teams trust it

Denials worked. Revenue recovered.

Live denials
|
Mapping each denial code
24/7
Works the denial queue overnight
HITL
Staff approve the appeals
Every denial
Read and worked, never aged into a write-off
The process

How it works

Step 1

Reads the denial

Works through the remittances and electronic remits, reads each denial code, and figures out why the claim denied and whether it's recoverable.

Step 2

Corrects & resubmits

Maps the denial code to the fix - a missing modifier, an eligibility error, a coding issue - repairs the claim, and resubmits it clean.

Step 3

Appeals & escalates

For denials that need to be argued, it assembles the appeal packet with the supporting records and routes it to staff to review and sign off.

Watch it work

From denial to resubmitted, end to end

It reads the denial on the remittance, maps the code to the correct fix, repairs the claim, and resubmits it clean - or assembles the appeal packet when the claim needs to be argued.

Remittance - claim #C-90213
REMITTANCE - DENIAL
Claim #C-90213 - ERA received today
Aetna PPO
Denial code
CO-16 - missing modifier
CPT99214
Billed$220.00
ReasonModifier 25 required
At risk
$220.00
Waystar
Claim
Denial
Fix
Action
Status
Source
Claim
Denial
Fix
Action
Status
Integrations

Works in the tools you already use

WaystarChange HealthcareAvailityEpicathenahealthSlack
Questions

Frequently asked

Collections is about calling on overdue balances. This is claim-level payer rework: it reads payer denial codes on the remittance, corrects and resubmits the claims that can be fixed, and assembles appeals for the rest. Different work, different system - the denial queue inside your clearinghouse, not the phone.

Related

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