A $2,400 balance remains open. The balance alone does not show whether the claim was denied, information was requested, or follow-up is underway.
Health systems / revenue cycle management
Collect What You’ve Already Earned
The care was delivered; the claim is stuck between a denial, a documentation request and a follow-up nobody closed. Ana follows every open balance to where the work stopped, and hands billing the next step — not another resubmission.
[ the difference ]
Rebill and Wait, or Work the Next Step
today
- An open balance says nothing about why it’s open
- Claim, remit and follow-up live in three systems
- Denials resubmitted without the missing piece
- Underpayments found at year-end, if at all
with textql
- Every open balance sorted by why it’s open
- Claim, payor response and follow-up in one timeline
- Each denial worked with the fix it needs
- Every remit checked against the contract as it lands
[ 01 walk ]
See Where This Month’s Revenue Leaked
Expected and collected never match, and the gap is three different problems. Ana walks this month’s revenue from what the contracts say you’re owed to what arrived — denials, underpayments, and the follow-ups that stalled.
- Expected revenue from the contract in force
- Every remit read as it lands, not at month-end
- The gap split by why, and by payor
net revenue · this month −$4.90 M · -11.7%
$0.10 M · axis from $35.00 stalled follow-up −$1.40
[ 02 trace ]
Find Where the Follow-Up Stopped
A balance alone doesn’t say whether the claim was denied, the payor asked for something, or someone is already on it. Ana puts the claim, the payor’s responses and the follow-up tasks into one timeline, so the next step is obvious.
- Payor responses read from 277CA and 835 as they land
- Follow-up tasks joined from the work queues
- The next step named, with who owns it
claim · clm-3208
Outpatient surgery, $2,400 open
- 04/03 Claim submitted clm-3208 · outpatient surgery $2,400
- 06/06 Balance still open 64 days · a/r 60–90 $2,400
$2,400 open for 64 days. Resubmit? $2,400
[ 03 act ]
Every Next Step, Owned
A worklist sorted by age is a list of guesses. Ana routes each stalled claim with its next step to the team that owns it — billing, coding, payor relations — and keeps the timely-filing clock in front of whoever is closest to it.
- Each claim routed with its next step attached
- Timely-filing deadlines escalated before they pass
- Payor patterns sent to the team that can change them
/ ask ana
What happens to this week’s stalled follow-ups?
1,420 claims routed, each with its next step and an owner.
- billing Confirm receipt on 612 claims with records sent
- coding 188 CO-16 denials missing modifier 25
- payor rel. Payor B paying below the 2026 rate on 97 claims
- rcm lead Timely filing closes within 14 days on 41 claims
in practice / story preview
Find where the follow-up stopped.
A billing workflow connects an unpaid claim to the payor response and the work already completed.
Bring the claim, the payor’s request for documentation and the dated follow-up task into a single sequence.
Documents were sent, but receipt is unconfirmed. The next review starts with that unresolved step rather than a repeated submission.
Inside the workflow
- Locate claim CLM-3208 and its outstanding balance.
- Connect the April 12 payor response to the April 18 follow-up.
- Confirm receipt and current status with the payor.
what the team takes into review
A claim timeline with an explicit next step
Review Your A/R
Bring your open A/R and a year of remits. We join them inside your cloud and hand billing the stalled claims, each with its next step.
- 01A 30-minute call to pick the payors and the balances in scope
- 02We connect inside your cloud under a BAA — nothing leaves your environment
- 03Your billing team works the stalled claims with us
[ use cases ]
Where Revenue Cycle Starts
- 01 Denial management
Sort every denial by what it needs — a modifier, a record, an auth — and route it to the team that can fix it, with the payor’s own words attached.
- 02 Underpayment recovery
Check every remit against the contract in force on the date of service and total what each payor owes you, by contract term.
- 03 Timely filing
Watch every open claim against its payor’s filing limit and escalate the ones about to lapse, before the money is gone for good.
- 04 Prior authorization and documentation
Catch the services that keep denying for missing auth or records, and fix the front end that sends them.
- 05 Payor performance
Days to pay, denial rates and underpayments by payor, ready for the next contract conversation.
- 06 A/R forecasting
Forecast cash from the open balances and how each payor actually behaves, refreshed as remits land.
Read access, inside your environment, to your billing data, a year of 835 remits and 277CA responses, your work queues and your payor contracts. We join them and walk billing through the stalled claims.
[ try textql ]