Skip to content

Automation for healthcare billing and revenue cycle teams

Billers spend their afternoons logging into payer portals, checking claim status and re-keying what they find. The checks run overnight, the results land in the practice system, and the team starts the day with a short list of claims that actually need a call.

Start a free evaluationBook a 20-minute call
  • Free evaluation
  • Fixed quote before work begins
  • First deliverable running in 14 days, guaranteed

What this costs you today

A billing team of four or five lives in two places at once: the practice management system and a dozen payer portals. Eligibility gets checked one patient at a time before each visit. Claim status gets checked one claim at a time after 30 days. Remittances arrive as PDFs and 835 files that someone opens, reads and posts by hand.

None of this is hard. All of it is slow, and it competes with the work that brings money in. Denials sit because the person who would appeal them is still on a portal checking status on clean claims. A remittance posted a week late makes the aging report wrong for a week.

Call a fully loaded biller $45,000 a year, as an illustration. If two of them spend half their week on portal lookups and status checks, that is about $45,000 a year on work a computer can do at 3 a.m.

The manual tasks on these teams

What CBIT builds instead

We build scheduled jobs that log into each payer portal the way a biller does, run the eligibility and claim status checks for the day, and write the answers back into the practice system. Nobody watches a spinner. The results are there when the office opens.

Claims that come back paid, pending or in process are left alone. Claims that come back denied, rejected or unrecognized go on a worklist with the payer's reason attached, sorted by dollar value and timely-filing deadline. The team works that list instead of hunting for it.

Remittance files are read and matched to claims automatically. Anything that matches posts. Anything that does not match is set aside with a note on why. A person reviews the exceptions, which is a short list, not the whole file.

This is plain automation. The rules are the ones your billers already follow. We use newer tools only where they clearly earn their place, such as reading a scanned explanation of benefits that has no structured file, and we tell you when we do.

Safe to automate

  • Eligibility and claim status checks on commercial payer portals, run overnight and written back to the practice system.
  • Status follow-up on workers' comp, auto and liability claims, where the carrier has a portal or a scheduled call can be placed and the answer recorded.
  • Matching 835 remittances and paper EOBs to claims and posting the ones that match to the line.
  • Sorting incoming faxes, scanned forms and email attachments to the right patient, claim or worklist.
  • Building denial and aging worklists by dollar value and timely-filing deadline.
  • Reminders and checklists that run on a schedule, without anyone remembering.

Still needs a person

  • Deciding whether to appeal a denial, and writing the appeal. The rules vary by payer and the reason on the remit is often not the real reason.
  • Anything that changes a patient's balance or a charge. The automation lists it; a biller decides it.
  • Calls with a patient about money or coverage. The first contact on a sensitive matter is a person.
  • Underpayments and contract disputes, where the answer depends on reading the contract, not the remit.
  • Coding questions. The automation can flag a mismatch; a certified coder settles it.

How we handle your data

  • We approach our work the way a SOC 2 or HITRUST auditor would look at it.
  • We sign Business Associate Agreements (BAAs).
  • Most of what we build runs on your own resources: your servers, your cloud account, your logins.
  • Client data is never used to train public AI models.

The full picture, including where automations run and how logins are kept: how we handle your data.

Three scenarios we see on these teams

The shape of a typical engagement, with the names left out. Hours are illustrations of what a team this size usually gets back.

Scenario 1

Eligibility checks before every visit

About 10 hours a week back

Before

A front-desk coordinator pulls tomorrow's schedule at 3 p.m. and checks eligibility for 60 patients across seven payer portals. Two hours, most days, and the last ten get skipped when the phone rings.

After

A job runs at 6 p.m. against the next two days of appointments, checks every payer, and flags the patients whose coverage is inactive or changed. The coordinator reviews eight flags in the morning instead of checking 60 portals.

Scenario 2

Claim status follow-up at day 30

About 25 hours a week back

Before

Two billers split an aging report every Monday and spend the week checking claims that have not paid. Most are simply still in process. The ones that are actually stuck get found on Thursday, if at all.

After

Every claim past 25 days is checked automatically each night. Paid and pending claims drop off. The billers get a Monday list of only the denied, rejected and unrecognized claims, with the payer's reason code attached, and start appeals on day one instead of day four.

Scenario 3

Posting remittances and reconciling deposits

About 12 hours a week back

Before

Remittance PDFs and 835 files arrive by email and portal download. A biller opens each one, matches line items to claims and posts them. Bank deposits are reconciled against the postings at month end, and the differences take days to explain.

After

Files are picked up automatically, matched to claims and posted the same day. Unmatched lines land on an exception list with the amount and the reason. Deposits reconcile in minutes because the postings are already there.

Tasks we see on these teams

Plain automation

Automate looking up statuses on vendor and carrier portals

An automation checks every portal overnight and hands the team only the exceptions.

Automation, AI where needed

Automate status checks and follow-up calls that put someone on hold every afternoon

The checks happen on their own. Exceptions come back with everything already filled in.

Plain automation

Automate checking one system against another

Records processed, exceptions flagged, run before the day starts. Ran today in 0:48.

Automation, AI where needed

Automate renaming, sorting and filing documents that arrive by email

They land in the right place, named the right way, the moment they arrive.

Run your own numbers.

Set to a typical team doing this work by hand. Change it to match yours.

People doing this work

2

Hours each, per week

Half an hour counts. 40 is a full week.

20

Fully loaded cost per person, per year

Salary, benefits, taxes, overhead. $45,000 is an illustration; set it to yours.

$45,000

Time spent on this task

40 hrs / week

About 2,080 hours a year of a person's time.

Labor value of that time
$45,000 / year
Your project price
Fixed quote after a free evaluation
Tell us about this taskShare these numbers

These figures show the value of time spent on the task, not a project quote or guaranteed cash savings. We will help estimate what can realistically be automated.

Other industries

Not sure which task first?

Half a day with your team. Every task, ranked by what it costs you.

The Automation Inventory. $500, credited in full toward your first build. Optional: if you already know the task, the evaluation and the quote are free.

How the Inventory works

Tell us about the task your team keeps doing by hand.

Every morning, every Friday, or every time an order comes in. Small tasks and larger workflows are both welcome. The evaluation is free, and if we take it on, the first deliverable is running in your operation within 14 days, guaranteed.

Tell us about your taskBook a 20-minute call

Free evaluation. Fixed quote before work begins.