Denials start long before billing.
A missing signature at intake. An authorization that ran out on a Friday. A payer manual that changed last month. By the time a claim is denied, the mistake is weeks old. We build software that catches it where it starts.
Three causes, one letter
- Week 1Intake packet missing a consent signature
- Week 3Authorization units run out mid-program
- Week 4Payer updates its documentation rule
Traced back. Every cause is weeks older than the denial.
The seven-week claim, traced back.
Scroll down from the denial. Each cause sat in plain view for weeks. Here is where it started, and who on the crew now catches it while it is still small.
Claim denied. Three causes, one letter.
By now the session is long over. Fixing it means pulling the chart, finding the signer, and resubmitting.
Payer updates its documentation rule
The manual changed. Nobody on staff had time to read it.
Dana Walsh approves it.
Authorization units run out mid-program
Sessions kept happening after the units were gone.
Angie reviews and sends it.
Intake packet missing a consent signature
The first mistake, made on day one, at the front desk.
Angie gets it signed.
Catch it at the front desk, not the denial letter.
That is the whole idea. The crew checks early; your team makes the call.
The problem
Small centers are drowning in payer rules.
Every Medicaid plan writes its own rules for the same service. Staff learn them by getting denied. The work that prevents a denial is real, but it is reading and checking, not care. That is the work we hand to the crew.
A large hospital
Revenue teamCompliance officePolicy libraryA 40-bed rehab center
Billing leadClinical directorA stack of payer manuals that each change on their own scheduleWhat we hold to.
These shape every screen we build and every agent we ship. Pick one.
The crew reads, checks and drafts. A person with the right seat confirms. Agents never sign and never send anything outside on their own.
Dana Walsh confirmsBilling leadEvery demo, screenshot and walkthrough uses made-up clients. Real records stay inside your workspace.
Jorge R.
Maya T.
Arjun K.SampleWe sign a business associate agreement, encrypt records, and log who saw what. See security and our subprocessors.
Every flag points back to the rule, note or signature it came from. If the crew cannot read a source, it says so instead of guessing.
Your staff should understand every screen without a glossary. Guide answers in English and Spanish.
GuideThree units are left on this authorization.ENAny agent can be switched off per role, and every switch is recorded with a reason.
IntakeRecorded with a reasonBuilt for Ohio Medicaid and its plans first.
We start where the rules are hardest to keep up with: Ohio Medicaid and the managed care plans most behavioral health centers bill. More states follow once each payer is read in full.
Ohio Department of MedicaidState program rules
CareSourceManaged care plan
Molina HealthcareManaged care plan
AmeriHealth CaritasManaged care planHow we work with you.
Small steps, real payers, your team in the loop the whole way.
- 1
Step 1
One payer, one program
We start narrow, with the payer that costs you most in denials.
CareSource - 2
Step 2
Seats before agents
We map your roles first, so every agent knows who confirms its work.
Dana
MichaelAngie
Juan - 3
Step 3
Read in the open
Scout reads the payer's rules and your team approves each one. - 4
Step 4
Widen when it works
Add payers, programs and agents once the first one earns its place.
CareSourceMolina HealthcareAmeriHealth Caritas
Tell us which payers you bill.
A person reads every message. Write to hello@confirmity.app or book a 30-minute walkthrough.