PHASE 1
Discovery & Setup
Initial Assessment
- Systems Review: We identify your EHR, RCM, and payer contract systems
- Data Mapping: Map your claims data fields to our platform
- Security Setup: Execute BAA and establish secure data connections
- NDAs: Non-disclosure agreements that will allow a deep dive
Technical Requirements
What We Need Access To:
Secure API or SFTP access to claims data • Access to remittance files (835) and claim files (837) • Designated IT contact for integration support
PHASE 2
Configuration & Testing
Data Connection
We support various integration methods, including:
- API Integration - Real-time data sync (preferred)
- SFTP Batch Processing - Scheduled file transfers
- HL7/FHIR Interface - Standard healthcare messaging
- On-Premises Server Integration
Business Rules Setup
- Configure QPA thresholds for dispute initiation
- Set up automated timeline tracking (30-day negotiation, 4-day IDR window)
- Establish user roles and permissions
- Import 6 months of historical claims for baseline
Project Proposal Presentation
Executive Stakeholder Review:
- Live demonstration of configured platform
- ROI projections based on your historical data
- Workflow validation with department heads
- Formal approval for production launch
- Success metrics and KPI agreement
User Training
Quick-start training modules:
Platform Navigation
30 minutes
Claim Intake & Prioritization
45 minutes
IDR Submission Workflow
60 minutes
Reports & Analytics
30 minutes
PHASE 3
Go-Live
Final Testing
- Process test claims through complete workflow
- Validate document generation
- Confirm payment reconciliation
- Run performance checks
Launch Support
Dedicated Support During Launch:
Daily check-in calls during first week • Real-time issue resolution • Performance monitoring • Initial ROI tracking setup
POST-LAUNCH
Ongoing Optimization
📞 Accessible Customer Service
Available for immediate assistance and questions
📊 Monthly Check-ins
Regular reports and performance reviews
📈 Quarterly Business Reviews
Comprehensive ROI analysis and strategic planning
🔧 Continuous Optimization
Platform enhancements and workflow refinements
Integration Options by Provider Type
🏥 Large Hospital Systems
- Direct EHR integration (Epic, Cerner, Athena)
- Multi-facility consolidated reporting
- High-volume batch processing
- On-prem solutions available
🏥 Small Hospital Systems
- Streamlined EHR integration
- Right-sized implementation process
- Cost-effective cloud-based solutions
- Flexible deployment options
👨⚕️ Medical Groups & Practices
- Cloud-based API connections
- Simplified workflows for smaller volumes
- Focus on high-dollar claims
- On-prem solutions available
🏢 Ambulatory Surgery Centers
- Specialized anesthesia billing integration
- Facility/professional split handling
- Rapid dispute generation for time-sensitive claims
- On-prem solutions available
What We Need From You
Access Requirements
- Claims data feed (API, SFTP, or HL7)
- Historical out-of-network claims (6 months)
- Payer contract information
- Designated integration team contact
Time Commitment
- 2-3 hour discovery session
- 4 hours total training per user
- 30-minute daily check-ins (first week)
- 1-hour weekly optimization calls
Security & Compliance
All integrations include comprehensive security and compliance measures:
🔒 HIPAA-Compliant Data Handling
🔐 Encrypted Data Transmission
👤 Role-Based Access Control
📋 Audit Logging & Monitoring
📄 Business Associate Agreement (BAA)