Billing, Payments & Insurance AutomationPurpose
1.2. Automatedly validate patient health savings or flexible spending account eligibility for therapy-specific codes and reimbursement.
1.3. Automating real-time insurance verification during patient intake or billing stage to ensure compliant transactions.
1.4. Automate claim preparation by confirming coverage, eligibility, and deductible status for lactation services during scheduling or payment.
Trigger Conditions
2.2. Patient initiates payment using HSA/FSA.
2.3. Billing entry created for a therapy session with relevant CPT/ICD codes.
2.4. Automated intake form completed and submitted.
Platform Variants
3.1. Twilio SMS
• Feature/Setting: Automate text notifications requesting verification details; Twilio’s "Programmable SMS" API for eligibility prompts.
3.2. SendGrid
• Feature/Setting: Automates email reminders for documentation; SendGrid’s "Mail Send API" for eligibility results.
3.3. Salesforce Health Cloud
• Feature/Setting: Automates insurance verification via Health Cloud’s "Insurance Verification" integration.
3.4. Zapier
• Feature/Setting: Automator for combining form submissions with HSA/FSA verification APIs using "Webhooks by Zapier".
3.5. DocuSign
• Feature/Setting: Automates consent collection with automated eligibility confirmation using "Document Creation" API.
3.6. Plaid
• Feature/Setting: Automates verification of HSA/FSA account validity using Plaid’s "Auth" endpoint.
3.7. Slack
• Feature/Setting: Automate real-time team notifications with incoming eligibility result updates using "Incoming Webhooks".
3.8. Google Sheets
• Feature/Setting: Storing automated eligibility status; Google Sheets’ "API append row" automatedly for tracking.
3.9. Stripe
• Feature/Setting: Automates conditional payment processing with "Payment Intents API" to hold charges pending eligibility confirmation.
3.10. Kareo
• Feature/Setting: Automate insurance verification via Kareo’s "Eligibility Check" API for each appointment.
3.11. Athenahealth
• Feature/Setting: Utilize "Eligibility API" to automatedly validate HSA/FSA before claims submission.
3.12. Availity
• Feature/Setting: Automated insurance verification through Availity’s "Eligibility & Benefits" API connection.
3.13. Square
• Feature/Setting: Automates flexible payment option prompting using "Square Customers API" and "Invoices API".
3.14. QuickBooks Online
• Feature/Setting: Automate invoice tagging based on eligibility result via "Invoice API".
3.15. HealthSherpa
• Feature/Setting: Automates plan verification using "Eligibility Check" integration for lactation services.
3.16. Bluefin
• Feature/Setting: Secure payment workflow automation using "PayConex" API with eligibility result logic.
3.17. SimplePractice
• Feature/Setting: "Client Eligibility Verification" feature configured for automated insurance checks.
3.18. Greenway Health
• Feature/Setting: Automates eligibility queries with "Intergy API" for HSA/FSA coverage.
3.19. Doxy.me
• Feature/Setting: Automates patient intake eligibility forms using "Pre-Call Questionnaire" setting.
3.20. Epic Systems
• Feature/Setting: Epic’s "Eligibility Inquiry Integration" automates insurance status checks per patient visit.
Benefits
4.2. Enables real-time automated confirmation, accelerating billing cycles.
4.3. Reduces manual errors and denials through complete automation.
4.4. Enhances patient experience with automated, instant feedback.
4.5. Provides automated compliance trail for audits and billing accuracy.